Access to prescription insurance and medication use during the COVID-19 pandemic among First Nations people living off reserve, Métis and Inuit in the provinces, 2021
Released: 2024-10-15
Lack of access to prescription insurance has been linked to adverse health impacts, particularly for marginalized populations who experience a higher burden of pre-existing conditions and inadequate access to health care.
A new study, titled "Access to prescription insurance and medication use during the COVID-19 pandemic among First Nations people living off reserve, Métis and Inuit in the provinces" explores topics such as prescription insurance coverage, medication needs, and non-adherence to prescription medication due to cost within the Indigenous and non-Indigenous populations.
Over one in five Métis, Inuit, and non-Status First Nations people living off reserve had no prescription insurance coverage
In the spring of 2021, about one in seven First Nations people living off reserve (14%), one in five Métis (21%), one-quarter of Inuit (24%E) (see Note to readers), and one in five non-Indigenous people (21%) reported having no prescription insurance coverage in the 12 months prior to the survey.
Chart 1
Prevalence of prescription insurance in the past 12 months, by identity group and duration of coverage, Canada (provinces only), 2021
Non-Status First Nations people living off reserve (23%) were nearly twice as likely to report having no prescription insurance coverage in the year prior to the survey compared to Status First Nations people living off reserve (12%).
Chart 2
Prevalence of prescription insurance in the past 12 months among First Nations people living off reserve, by Status and duration of coverage, Canada (provinces only), 2021
Higher prevalence of medication needs observed among First Nations people living off reserve and Métis to treat several conditions including mental health conditions and chronic pain
The proportion of Indigenous people who had medication needs in the 12 months prior to the survey varied across groups, ranging from over half of Inuit (56%) to 7 in 10 Métis (70%). About two-thirds of First Nations people living off reserve and non-Indigenous people had medication needs during this period (67%).
Chart 3
Percentage of individuals who reported not adhering to their prescriptions because of cost among those who had medication needs in the past 12 months, by identity group and duration of coverage, Canada (provinces only), 2021
Compared with non-Indigenous people, First Nations people living off reserve and Métis were significantly less likely to require medication to treat cardiovascular conditions but were more likely to require medications to treat other conditions such as mental health conditions and chronic pain. The largest difference was for medications to treat mental health conditions; the proportion of Indigenous people requiring these medications was almost 10 percentage points higher than that of non-Indigenous people (First Nations people living off reserve: 27%, Métis: 27%, Inuit: 26%E, and non-Indigenous people: 18%).
Not adhering to prescription medication because of cost was two to three times higher for those lacking full-year prescription insurance coverage
Among individuals with medication needs, 11% of First Nations people living off reserve, 12% of Métis, 23%E of Inuit, and 9% of non-Indigenous people reported not adhering to their prescription medication because of cost (e.g., delayed filling prescription, skipped doses). However, within each identity group, those who lacked full-year prescription insurance coverage (i.e., had no coverage or had part-year coverage) were two to three times more likely to not adhere to medications because of cost than those who had full-year coverage in the 12 months prior to the survey.
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Note to readers
This study was a collaboration with the Congress of Aboriginal Peoples, carried out as part of the Transformational Approach to Indigenous Data with the goal of building Indigenous data capacity and improving the visibility of Indigenous People in Canada's National Statistics.
Estimates that are followed by an E indicate high variance (coefficient of variation > 15.0%) and should be interpreted with caution. Estimates for Inuit could not be provided for all outcomes due to small sample sizes.
Data source
The survey used for this analysis was the Survey on Access to Health Care and Pharmaceuticals During the Pandemic (SAHCPDP), which was administered between March 8 and May 15, 2021. The reference period was the past 12 months.
The target population for the survey was persons 18 years of age and older living in the 10 provinces, and excluded persons living on reserves and other Indigenous settlements in the provinces and the institutionalized population. The survey was administered by electronic questionnaire and computer-assisted telephone interviews. An oversample of Indigenous people living in the 10 provinces was included to increase the reliability of estimates for First Nations people living off reserve, Métis and Inuit. The additional sample was drawn from those who identified as Indigenous in the 2016 Census.
Concepts
Prevalence of prescription insurance coverage: the SAHCPDP asked respondents about the duration of their prescription insurance coverage in the past 12 months. Respondents could indicate that they had coverage for all of the previous 12 months (full-year coverage), part of the previous 12 months (part-year coverage), or that they did not have coverage (no coverage).
Note: The Non-Insured Health Benefits program (NIHB) is a federally-run program that provides coverage for a range of health benefits, including prescription medications, to Status First Nations people (i.e., a First Nations person who is registered under the Indian Act) and Inuit recognized by an Inuit land claim organization. Eligibility for coverage under NIHB may account, in part, for differences in prevalence of prescription insurance coverage between certain Indigenous groups as measured in the study. However, the survey did not allow direct measurement of this as information on insurance type and provider were not available.
Medication needs refers to those who reported taking or being prescribed any prescription medication in the past 12 months.
Non-adherence to prescription medication due to cost (or medication non-adherence in short) refers to engaging in one or more of the following behaviours because of prescription medication costs:
1. Not fill or collect a prescription
2. Skip doses of your medication
3. Reduce the dosage of your medication
4. Delay filling a prescription
Status First Nations people and non-Status First Nations people: Status First Nations people refers to First Nations people who responded "Yes, Status Indian (Registered or Treaty)" in response to the following question: "Are you a Status Indian (Registered or Treaty Indian as defined by the Indian Act of Canada)?". Non-Status First Nations people refers to First Nations people who responded "No" to this question.
Products
The publication "Access to prescription insurance and medication use during the COVID-19 pandemic among First Nations people living off reserve, Métis and Inuit in the provinces" is now available as part of the Indigenous Peoples Thematic Series (41200002).
Contact information
For more information, or to enquire about the concepts, methods or data quality of this release, contact us (toll-free 1-800-263-1136; 514-283-8300; infostats@statcan.gc.ca) or Media Relations (statcan.mediahotline-ligneinfomedias.statcan@statcan.gc.ca).
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