DETERMINANTS OF HEALTH IN CANADA

OVERVIEW

In my previous blog, I discussed about health, W.H.O definition of health and a need to modify the definition of health. In this blog, I will discuss determinants of health in Canada and how these determinants influence health and disease distribution in Ontario.

DETERMINANTS OF HEALTH IN CANADA:

Determinants of health are defined as a large range of factors that influence the health status of individuals or populations.

The public health agency of Canada currently listed twelve determinants of health

1. Physical environment;

2. Employment and working condition;

3. Social environment;

4. Social support networks;

5. Health services;

6. Culture;

7. Income and social status;

8. Education and literacy;

9. Personal health practices and personal skills;

10. Healthy child development;

11. Biology and genetic endowment;

12. Gender.

Many of these determinants are grouped under the general heading of socio-economic status (SES) or could be considered as facets of SES.

• SES as a determinant of health: It represents the person’s position in society in terms of income, living, employment etc. Using different indicators to assess and measure the health status strongly highlights the role of socio economic status. Individuals or communities with low socio-economic status have lower life expectancy as compared to individuals and communities with high socio-economic status.

• Education as determinant of health: Education plays a significant role in many aspects of health. Education act as a ladder to reach to better employment and resources. Education enables individuals to understand the risk factors of diseases and how to improve health and well being. A group of educated individuals or communities play a vital role in improving societal factors related to their health and well being. As compared to other countries, 50% of Canadians have post-secondary education, children in Canada whose parents don’t have secondary education performs worst as compared to children of educated parents (The Canadian facts, 2010).

• Income (poverty) as a determinant of health: Our overall living condition depends upon the income we get, it has a direct effect on mental health, quality of diet, housing, tobacco and alcohol use. It is estimated that 9% or 1.1 million household in Canada experiencing food insecurity. The Canadian community health survey found that food insecurity is more in families having children (10.4%) as compared to families who don’t have kids (8.6%), it is more common in households led by lone mothers (25%). Ab original household suffers more from food insecurity as compared to non-ab original houses (The Canadian facts,2010).

• Gender as a determinant of health: Gender can affect health because of different roles and responsibilities belongs to people according to their gender. In Canada, the income of women is less, and they are employed in lower paying occupation as compared to men. Men get higher salary as compared to women, even if they are working in same field. Women have a life expectancy of 79 years as compared to men’s 76.3 years. Women suffers more from long term disabilities and chronic illness. On the other side, men experience more accidents and injuries which reduces their overall life expectancy.

• Health care as a determinant of health: health care includes services to promote health, prevention diagnosis and treatment of diseases. The Canadian Health Act highlights the medically necessary services that must be provided as insured health services in every province and territory. However, these insured health services do not cover prescription drugs, vision and dental care, home care and long-term care. A 2012 report by Public Health Ontario found that families having low financial status had fewer visits to the dentists as compared to upper class families (48.9%, compared to 84.1%) and the highest rate of visiting a dentist only for emergency services (43.8%, compared to 7.7% in highest-income households).

CONDITIONS OF HEALTH IN ONTARIO IN TERMS OF FINIANCIAL STATUS(INCOME)

Generally, Ontarians are healthy, receiving high quality health care and having longer life expectancies i.e., 79.2 for males and 83.6 for females (2007/2009). But that’s not the case for everyone, some people in the same province are not as healthy as other, not receiving health services and suffering from adverse health outcomes. The financial(income) or social status of an individual has direct effect on his/her health.

The smoking rate among poor people in Ontario is 22.1% as compared to rich people i.e., 14.4% and 18% for overall Ontario. Insufficient intake of fruit and vegetables by poor people (65.2%), compared with 56.7% for richest people. The poorest people in Ontario are nearly double as likely to report having multiple chronic conditions as the richest people.

54.3% of Women living in poor urban neighborhoods have had their cervical screening in last three years as compared to women living in richest urban neighborhood i.e., 66.7%. 49.7% of poor people are waiting for colorectal cancer screening as compared to only 34.9% of rich people. Nearly 6 out of ten poor people having insurance for prescription medication compared with almost 9 out of ten of rich people. Poor people visited 109,494 times emergency department and rich people visited only 54,457 times over a last three-year period.

Women living in poor urban neighborhood dies 2 years earlier as compared to women living in rich urban neighborhood. Men in poor urban neighborhood dies 5 years earlier as compared to men living in richest urban neighborhood.

While searching for this topic, I realized that there is a deep relationship between health and financial status and it is the main cause of health inequity in many countries of the world. If you are earning more you can easily access high quality health care, you can spend more on healthy food and have greater life expectancy.

ENDING THOUGHTS

From my perspective, if government of Canada spend more on social services as compared to health care services like spending on programs for people with disabilities, helping low income families and help them to find employment, providing shelter to homeless people, it will improve the overall outcomes of population health for sure and decreases health inequity.

REFRENCES:

uOttawa. The society, the individual, and medicine. (2017,AUG 2). Determinants of health in Canada Retrieved from https://www.med.uottawa.ca/sim/data/Pub_Determinants_e.htm#SES

Mikkonen and Raphael. (2010). the Canadian facts retrieved from http://thecanadianfacts.org/the_canadian_facts.pdf