Quebec’s English-Speaking Community in 2007

1. Quebec’s English-Speaking Community in 2007 Jennifer Johnson CHSSN

2. Population • 918 955 English-speaking Quebecers (FOLS), 2001Census of Canada • 12.9% of the population; significant variation from one region to another (from 0.5% to 36%) • Proportion of seniors: 10% higher than the average with respect to the French-speaking majority • 11 regions have 20% more seniors than the French-speaking majority (54% Estrie, 51% Lanaudière, 74% Laurentides) • Generation 40-65 years of age missing as a result of the 1976-1986 exodus

3. Aging community

4. The greatest decline (in absolute numbers) among all official language communities in Canada Growth and decline

5. English-speaking Quebecers: 26% more apt to have incomes below the LICO More than 20% in 7 of the 17 regions Single-parent families (vulnerable in terms of income security): 3% higher among English-speaking Quebecers throughout the province (36.5% vs. 33.7%) Low-income cut-off (LICO)

6. Unemployment • English-speaking Quebecers: Unemployment rate at 17% higher than their French-speaking neighbours • In 8 administrative regions: 30% or over • Only Francophones in New Brunswick have a higher unemployment rate

7. Weakening of social environments • Severe demographic loss outside of Montreal in recent decades • The community’s size and proportions vary significantly (0.5% to 36.1%) • Aging communities (13 regions out of 16) with low proportion of caregivers in 8 of the 16 communities • Loss of institutions and loss of volunteer age groups • Propensity to turn to family members in case of illness; however, the family is less likely to be nearby • 60% of English-speaking Quebecers believe that the future of their regional English-speaking community is threatened

8. Compared with the three other official languages groups Francophone Quebecers Francophone minorities outside of Quebec Anglophone Canadians English-speaking Quebecers have the lowest rates among all groups in terms of: Having a regular doctor Satisfied health needs Satisfaction with regard to care received Utilisation of hospital services Utilisation of a doctor’s services Ease in accessing specialists Quality of care by a doctor Satisfaction regarding care given by community services Ease in obtaining tests Ease in accessing health information Ease in getting immediate care Canadian Community Health Survey Utilization of health services

9. Satisfaction pertaining to access to health and social services – CHSSN / CROP survey • Fewer than half of the English-speaking respondents are satisfied with their access to health and social services in English, in their region (45.9%) • The highest rate of satisfaction in terms of access to services in English is found among Anglophones aged 65 years and over • Those who consider their health status to be fragile are more likely to express low levels of satisfaction 4 or 5 on a scale of 5 points

10. Utilization of health and social servicesCHSSN / CROP survey • English-speaking respondents are less likely to call upon public health and social services than their French-speaking counterparts • Doctor in a private clinic • CLSC • Info-Santé • Hospital emergency department • Hospital stay longer than one day

11. INFO-SANTÉ Surveys conducted in the Anglophone population, PHCTF project • About 60% of the population do not know the service exists • 70% of those who know the service exists do not know that the service is provided in English • The proportion of recent users has not increased since 1998 and remains at about 15% vs. 26% among French-speaking people • Anglophones attach importance to the fact that the Info-Santé service can be obtained in their language. Nonetheless, only slightly more than half (54%) have demonstrated a wish to receive the service in English

12. Utilization of English – CLSC (other than Info-Santé) CHSSN / CROP survey • Two thirds use English when calling upon CLSC services • There is a major difference within the Montreal region. 80.5% of English-speaking respondents in Montreal West receive CLSC services in English, compared with 38.6% of respondents in Montreal East

13. Obstacles to requesting services in English CHSSN / CROP survey • 18% of respondents report feeling ill at ease asking for services in English • In 8 regions, the rate of unease exceeds the provincial average • The most significant reason given for feeling ill at ease relates to efficiency (25% state that such a request can impose a burden whereas 22% say they are concerned that this request could cause a delay) • Again, significant differences are noted in the Montreal region

14. Health information and promotion CHSSN / CROP survey • 73% report having received NO information from public health and social service institutions concerning access to services in English in the course of the two years preceding the survey • This rate reaches close to 90% in some regions

15. General conclusions • Serious demographic challenges and varied access to the public health and social services network create inequalities regarding the health status of English-speaking communities in a number of regions • There is a link between the low income level in Anglophone communities, the observation of poor health status, and the low level of satisfaction with regard to services • Discrepancies in terms of access to services in English are evident in rural and isolated regions and between Montreal East and West. Certain services are significantly under-utilized (Info-Santé) • Nearly 1 Anglophone in 5 feels ill at ease requesting services in English. About half feel they are a burden or will experience delays getting services • The myth of a uniformly well-served Anglophone community in Montreal is dead. Anglophones in Montreal East have much less access to services in English than English-speaking people on the rest of the island