Public experiences and perspectives of primary care in Canada: results from a cross-sectional survey.

BACKGROUND: Through medicare, residents in Canada are entitled to medically necessary physician services without paying out of pocket, but still many people struggle to access primary care. We conducted a survey to explore people's experience with and priorities for primary care. METHODS: We conducted an online, bilingual survey of adults in Canada in fall 2022. We distributed an anonymous link through diverse channels and a closed link to 122 053 people via a national public opinion firm. We weighted completed responses to mirror Canada's population and adjusted for sociodemographic characteristics using regression models. RESULTS: We analyzed 9279 completed surveys (5.9% response rate via closed link). More than one-fifth of respondents (21.8%) reported having no primary care clinician, and among those who did, 34.5% reported getting a same or next-day appointment for urgent issues. Of respondents, 89.4% expressed comfort seeing another team member if their doctor recommended it, but only 35.9%, 9.5%, and 12.4% reported that their practice had a nurse, social worker, or pharmacist, respectively. The primary care attribute that mattered most was having a clinician who "knows me as a person and considers all the factors that affect my health." After we adjusted for respondent characteristics, people in Quebec, the Atlantic region, and British Columbia had lower odds of reporting a primary care clinician than people in Ontario (adjusted odds ratio 0.30, 0.33, and 0.39, respectively; p < 0.001). We also observed large provincial variations in timely access, interprofessional care, and walk-in clinic use. INTERPRETATION: More than 1 in 5 respondents did not have access to primary care, with large variation by province. Reforms should strive to expand access to relationship-based, longitudinal care in a team setting.

Brexit, COVID-19, and attitudes toward immigration in Britain.

OBJECTIVE: A key issue in Britain's referendum on European Union membership was the free movement of labor into Britain, with Brexit "Leavers" having more negative attitudes toward immigrants than "Remainers." Such anti-immigrant attitudes are driven by feelings of threat. The coronavirus pandemic presented a new threat in the context of ongoing Brexit negotiations. This paper examines how the COVID-19 pandemic affected anti-immigrant attitudes and how these effects differ between Leavers and Remainers. METHODS: Using an online survey in Spring 2020 of 3,708 individuals residing in the UK, we experimentally test the effect of priming COVID-19 thoughts on anti-immigrant attitudes, and examine whether this effect varies by Brexit identity. RESULTS: We show that COVID-19 may exacerbate anti-immigrant attitudes among Leavers while having little effect on Remainers. CONCLUSION: These findings support the idea that the coronavirus pandemic might have presented a new, viral, threat that heightened anti-immigrant attitudes among certain political identities.

Public Responses to Policy Reversals: The Case of Mask Usage in Canada during COVID-19.

Coronavirus disease 2019 (COVID-19) has resulted in rapid, substantial, and at times contradictory policy changes as public health agencies and government officials react to new information. We examine the implications of such changes for public compliance by drawing on the case of revised guidance on mask usage by asymptomatic individuals. As official recommendations on the use of masks in Canada shift from discouraged to mandatory, we draw on findings from an ongoing public opinion study to explore contemporaneous changes in rates of mask adoption and levels of public trust in government institutions. We find that Canadians exhibit high levels of compliance with changing policies on mask usage and that trust in public health officials remains consistent despite policy change.

La maladie du coronavirus 2019 (COVID­19) a poussé les organismes de santé publique et autres responsables gouvernementaux à apporter des changements rapides, importants et parfois contradictoires aux politiques, en réaction à la nouvelle information. Les auteurs étudient les répercussions de ces changements sur l'adhésion du public à ces décisions en se penchant sur le cas de l'évolution des directives quant à l'usage du masque par les personnes asymptomatiques. Les recommandations officielles relatives à l'usage de masques au Canada étant passées de la dissuasion à la contrainte, les auteurs étudient les constats tirés d'un sondage d'opinion publique en cours visant à analyser les fluctuations actuelles des taux d'adoption du port du masque et des niveaux de confiance du public dans les institutions gouvernementales. Les auteurs constatent que les Canadiens affichent des niveaux élevés d'adhésion aux politiques changeantes sur l'usage du masque et que la confiance dans les autorités de la santé publique demeure constante, malgré ces changements.