Routinely asking patients about income in primary care: a mixed-methods study

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Figure 1. Questions about income
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Figure 2. Responses to income questions. Responders are those who responded to both parts of the question. Non-responders answered ‘don’t know’, ‘prefer not to answer’, or left a question blank.

Table 1. Test of association between responding to two-part income question and sociodemographic characteristics of patients

Characteristic	Responders, n = 10 441, n (%)^a	Non-responders, n = 3806, n (%)^a	P value^b
Sex			P< 0.0001
Male	4435 (42)	1252 (33)
Female (reference)	5738 (55)	2133 (56)
Other^c	98 (1)	30 (1)
Missing	170 (2)	391 (10)
Age, years			P< 0.0001
<10	99 (1)	98 (3)
10–19	78 (1)	125 (3)
20–29	1294 (12)	625 (16)
30–39	2704 (26)	757 (20)
40–49	2117 (20)	618 (16)
50–59	1944 (19)	661 (17)
60–69	1327 (13)	494 (13)
≥70	878 (8)	428 (11)
Median (IQR)	44 (34–57)	44 (31–59)	P = 0.01
Language (spoken)
English (reference)	9764 (94)	3382 (89)	P< 0.0001
Other	624 (6)	316 (8)
Missing	53 (1)	108 (3)
Immigration status			P< 0.0001
Born outside Canada	4193 (40)	1689 (44)
Canadian born (reference)	6167 (59)	1677 (44)
Missing	81 (1)	440 (12)
Housing status			P< 0.0001
Own home (reference)	4301 (41)	1173 (31)
Rent	4846 (46)	1300 (34)
Other	935 (9)	359 (9)
Missing	359 (3)	974 (26)
Ethnic group			P< 0.0001
White (reference)	6128 (59)	1414 (37)
Non-White	3901 (37)	1636 (43)
Missing	412 (4)	756 (20)
Sexual orientation			P< 0.0001
Heterosexual (reference)	8173 (78)	2611 (69)
Gay, bisexual, lesbian, queer, two-spirit, or other	1777 (17)	345 (9)
Missing	491 (5)	850 (22)
Mental health
Severe mental illness^d	296 (3)	107 (3)	P = 0.99
Neighbourhood income quintile^e
Q1 (reference)	2469 (28)	1041 (32)	P< 0.0001
Q2	1458 (17)	543 (17)
Q3	1379 (16)	493 (15)
Q4	1399 (16)	417 (13)
Q5	2114 (24)	717 (22)

^aUnless otherwise stated. ^bχ2 for categorical and Mann-Whitney U Test for continuous variables (age) as age data not normally distributed; bold indicates statistically significant. ^cIncludes trans-FTM (female to male), trans-MTF (male to female), intersex, ‘other‘, and those who selected multiple sex terms. ^dIncludes patients with a bill submitted that includes the diagnostic code for schizophrenia, bipolar disorder, psychosis, paranoia, or psychosis not otherwise specified. ^eFor participants with a valid postal code (n = 8819 responders, n = 3211 non-responders), linkable to 2006 Census data on income. IQR = interquartile range. Q = quintile.

Table 2. Adjusted odds of responding to a two-part question on income

Covariate	Characteristic	AOR (CI)	P value^a
Sex	Female	0.79 (0.72 to 0.87)	< 0.001
	Other^b	0.92 (0.54 to 1.56)	0.762
	Prefer not to answer, do not know, or missing	0.51 (0.39 to 0.66)	< 0.001
	Male (reference)	1.0	n/a
Age, years	<10 versus 30–39	0.51 (0.36 to 0.74)	< 0.001
	10–19 versus 30–39	0.22 (0.15 to 0.31)	< 0.001
	20–29 versus 30–39	0.53 (0.46 to 0.62)	< 0.001
	40–49 versus 30–39	0.97 (0.84 to 1.12)	0.659
	50–59 versus 30–39	0.84 (0.73 to 0.98)	0.022
	60–69 versus 30–39	0.78 (0.67 to 0.92)	0.003
	≥70 versus 30–39	0.66 (0.56 to 0.79)	< 0.001
Housing status	Renting versus own home	1.15 (1.03 to 1.28)	0.013
	Other versus own home	0.86 (0.73 to 1.01)	0.067
	Prefer not to answer, do not know, missing versus own home	0.18 (0.15 to 0.21)	< 0.001
Ethnic group	Non-White versus White	0.62 (0.56 to 0.68)	< 0.001
	Prefer not to answer, do not know, or missing versus White	0.29 (0.25 to 0.34)	< 0.001
Sexual orientation	Gay, bisexual, lesbian, queer, two-spirit, or other versus heterosexual	1.42 (1.23 to 1.65)	< 0.001
	Prefer not to answer, do not know, or missing versus heterosexual	0.37 (0.32 to 0.43)	< 0.001
Income quintile	Q2 versus Q1	1.06 (0.92 to 1.22)	0.392
	Q3 versus Q1	1.04 (0.91 to 1.2)	0.554
	Q4 versus Q1	1.14 (0.98 to 1.32)	0.091
	Q5 versus Q1	0.98 (0.86 to 1.12)	0.752

^aBold indicates statistically significant. ^bIncludes trans-FTM (female to male), trans-MTF (male to female), intersex, ‘other‘, and those who selected multiple sex terms. Q = quintile. n/a = not applicable.

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