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This page contains all datasets generated over the course of a project aimed to identify and evaluate restricted health data sources in Canada for the purposes of improving the discovery of, and access to research data.

A grading rubric for evaluating access-limited data sources based on their ability to make their data clearly discoverable and accessible. This grading rubric was applied to 53 Canadian health data sources.

First paragraph: Enabling people with dementia to live independently in their own homes is a key objective of contemporary dementia care policy and practice. Frequently referred to as ‘ageing in place’, current health care policy across many western countries focuses upon ensuring people with dementia can stay at home as their dementia progresses, thereby delaying, reducing or avoiding the use of state services such as residential or nursing care (Brittain et al 2010; Kenner 2008; Roberts et al 2012; Buffel et al 2012). Such policy objectives typically have the support of older people themselves, with the majority routinely stating that they would prefer to remain at home for as long as possible (Oldman 2003; Lui et al, 2009). In order to support this objective, assistive technologies have been posited as a means to support people with dementia to remain at home (Sixsmith & Sixsmith 2008). Products defined as assistive technology can include a whole range of mobility aids and household adaptations, however in the context of people living with dementia, the term assistive technology is most often associated with electronic devices or services which can monitor a person’s activities, or products that can assist a person with daily functions (Gibson et al 2016).

This thesis contributes new knowledge to discussions of inequality in three arenas and two methodological syntheses that might inform future statistical analyses. Methodologically, the application of unconditional quantile regression in a two-stage model is used to determine whether response bias plays any role in the patterns observed in survey responses (Chapter 2), and, a recent development in the program evaluation literature (the synthetic control method) is combined with flexible parametric survival models to identify treatment effects where stratification is perfectly correlated with treatment (albeit under restrictive assumptions). The analyses undertaken herein have discovered: that self-assessed unmet need for healthcare has an empirical basis for application as reporting behaviour statistically predicts decline in health, that the likelihood of reporting unmet need conditional on health and healthcare utilization is correlated with the dimensions along which social scientists might map inequality, that government programs intended to provide a minimum level of utility are unresponsive to regional poverty-relief efforts, and that household bargaining outcomes regarding number of children can be predicted by exposure to a parental divorce. The implications of these findings are manifold. First, while self-assessment of healthcare access is a valid metric on average to overcome limitations of needs-adjusted utilization, its use in cross-sectional analysis as it is currently obtained in survey across many different jurisdictions is suspect. Second, the patterns of fertility conditional on parents’ divorce suggest that household bargaining in Canada does not likely belong to several different theoretical frameworks. Specifically, bargaining most likely exists in an environment where women still bear the cost of children in the event of a divorce, or bargaining exists without commitment. Finally, while the theoretical literature makes compelling claims about interactions between different levels of government policy, in practice this may not be the case even if policy-wordings seem to suggest this would be particularly relevant. Thesis Doctor of Philosophy (PhD) This thesis explores three separate dimensions of inequality. First, a method of improving measurement of inequity in healthcare is demonstrated in a world of heterogeneous preferences where traditional methods exploiting observed utilization are shown to be inadequate. Potential issues resulting from response bias in the metric used in the method from chapter 1 are investigated in chapter 2. Next, the experience of a parents’ divorce as a child is correlated with adult fertility showing that the intergenerational transmission of marital instability may influence decisions on family size as an adult, specifically, only women show a change in fertility outcomes after the exposure to their parents’ divorce. Finally, the effect of a regional transfer intended to improve living standards for the poor is examined for its effect on the workfare program in Ontario. The transfer is found to increase the duration of welfare benefit receipt by two months, representing a welfare improvement for eligible recipients.