Public Perceptions and Media Coverage of the Canadian healthcare System: A Synthesis

Stuart N. Soroka
McGill University


This report reviews the state of Canadian public opinion on healthcare, focusing on trends over the past five years. It combines a discussion of public opinion with an analysis of media content on healthcare issues. The first section is a continuation of work in previous state-of-opinion reports and follows a similar logic, reviewing results from all recent and readily available commercial polling on healthcare issues. The second section presents an entirely new exploration of communication and opinion in healthcare matters, presenting results from a content analysis of more than 100,000 articles on healthcare in major Canadian English- and French-language dailies from the past 15 years.


This combination of opinion and media analysis is intended to highlight the connection between public attitudes and media coverage of the Canadian healthcare system. It identifies trends in opinion, focusing in particular on public attitudes about quality, sustainability and public versus private provision of services. It reveals some gradual, long-term shifts in media content, including a recent period of “crisis”-oriented coverage. It also suggests that media content and public opinion are intimately linked. Individuals’ attitudes about their own doctors and hospitals are based on their own personal  experiences; their attitudes about the system-at-large are necessarily based in part on other sources of information, including media content.


The most important findings include the following:

  • Attitudes about the state of the Canadian healthcare system in general have shown slight improvement over the past five years.
  • Levels of approval for the current state of the healthcare system are somewhat lower in Quebec than elsewhere in Canada.
  • In spite of largely positive experiences with the healthcare system, there is a clear sense among Canadians that the system is in jeopardy and that it is, at a minimum, in need of “fairly major repairs,” and perhaps even “complete rebuilding.”
  • In particular, there is a sense that the current system is unsustainable, and that the most pressing issues include doctor shortages and wait times.
  • This apprehension is evident in government approval ratings as well. While general levels of approval have remained largely static, there is a downward shift in the proportion of respondents who feel that governments are likely to be able to improve the current system in the near future, plagued by a combination of financial constraints and inefficient management.
  • In turn, these concerns appear to have led to a steady (consideration) of alternative options, such as paying for quicker access, user fees, and privatization.
  • Indeed, there is majority support for private sector delivery of tax-supported healthcare services, and Canadians are nearly evenly divided on the issue of allowing people to pay for quicker access to healthcare services when the public system cannot provide timely access.
  • Where media are concerned, levels of coverage of healthcare issues have remained relatively high over time, though the emphasis on certain issues has varied.
  • The general trend over the past few years, in line with public opinion, has been away from discussion of wait times and doctor shortages; more recent coverage focuses somewhat more on disease outbreaks (e.g., H1N1 flu) and also fitness and nutrition.

There are some differences in coverage across regions as well. Eastern media coverage is more critical and more focused on failures of the current system; western media coverage includes a somewhat  greater  proportion of fitness and nutrition coverage.


The penultimate section of the report provides a first effort at directly linking trends in media content with trends in public opinion. The two clearly move in parallel. There is, this report suggests, a clear connection between media content and public opinion, both over time and across regions. Whether that connection reflects a causal effect of media on public opinion is not clear. But further analysis of media content can clearly add to our understanding of the sources and structure of public opinion on healthcare policy issues.