Inequality in health is a reality in Canada, even though our health care system is widely accessible. But there's much we can do — policies and initiatives that could lead us toward a future with healthier lives, and healthier communities.
The Canadian Institute for Health Information has just released this report, laying out a lot of great solutions, or at the very least, places to start. View the summary report here, and their interactive e-tool here.
Canadians spend a lot on health care, over $200 billion a year. But thanks to CIHIs latest report, we have even more evidence that inequality in health status between the richest and the poorest is growing even as we spend more dollars on care. This means we need to do things differently if we are going to improve the health of all Canadians, and make sure those improvements are enjoyed across all segments of society.
Since the early 2000s, inequalities have widened in self-reported mental health, smoking rates, and chronic lung disease. What explains these gaps are differences in income, differences which have also widened since the early 2000s, and how lack of income makes it more difficult for families to secure the necessities of healthy living.
For example, lower income families are more likely to live in overcrowded or unhealthy housing, or to live in housing which takes up too much of their monthly income. These families are more likely to have trouble getting the good food they need to stay healthy, which means their children are more often born under-weight or sent to school under-nourished. This means they aren't prepared to learn, and we see this reflected in the numbers of lower-income children who have difficulty succeeding at school. The daily stress of these living conditions means lower income families experience more mental illness, making it even harder to cope.
Solving these problems isn't what hospitals are built for, but it's factors like these - and other social determinants of health - which really matter to the good health of families. CIHI's report is valuable because it plainly explains these facts, but also because it provides many examples of tested interventions which can improve health equity in Canada. Initiatives like Housing Choices in the Northwest Territories provide targeted benefits to low income families, while broad-based interventions like the proposed guaranteed annual income ensure a closing of the health inequality gap across Canada. CIHI's report provides a well-developed agenda for action, and its recommendations deserve implementation.