It is a bit difficult, but there is some rather innovative work currently underway. The U.S., over the last few years, created what is referred to as the Literacy and Health in America Index. The International Adult Literacy Survey measures adult skills. It is a literacy test and people are asked to answer a number of questions, some directly related to health, namely the request for services, the issues of prevention and awareness. The results of this survey revealed that francophones fare far worse than others and are at risk. If people have less schooling and are less literate, their self-confidence is lessened, they also have a lesser sense of being able to understand what is happening to them when they are sick and what to do.
The literacy survey asks very elaborate questions. It is kind of like an exam which includes essay-type questions where people are asked to understand some information and use it in order to obtain answers. The issue of knowledge, the way in which to request health services, the issue of awareness and steps to take, are all major aspects of the survey and research has shown that francophones are far more vulnerable in this respect than anglophones.
The situation in Quebec is remarkable. We know where the anglophone population in Quebec stands, they have done very well on these tests. They are the population with the highest level of schooling among anglophone communities in Canada. The situation is clearly completely different, the problems are completely different as well.