Health inequalities are described by the Public Health Agency of Canada as, “differences in health status experienced by various individuals or groups in society. These can be the result of genetic and biological factors, choices made or by chance, but often they are because of unequal access to key factors that influence health like income, education, employment and social supports” (Government of Canada, 2008, p.5).
Indeed, in Canada as elsewhere, health is distributed along a gradient where those in lower social classes (who earn lower income, have lower levels of education, belong to an ethnic or racial minority group, are employed in jobs where their work is less valued, etc.) are more likely to suffer from a variety of diseases and are more likely to die at a younger age than those in social classes slightly above them and so on up to the highest social class.
|The distribution of health outcomes (diseases and mortality) is intimately related to public policy. Health inequalities can be created, exacerbated, or alleviated by public policies. At the National Collaborating Centre for Healthy Public Policy we seek to provide public health actors with the best available research and approaches for those working towards reducing these inequalities. |
Reducing Health Inequalities
The NCCHPP and the National Collaborating Centre for Determinants of Health have worked together to prepare a document which describes the various types of tools currently in use in Canada and elsewhere which attempt to address health inequalities at the local public health level. Currently in the revision stage, this document will help local public health actors choose the types of health equity tools that might be most useful in their contexts.
Analysis of Media Coverage of Inequalities
In 2009, the Centre contracted the Caisse Chartier Press Analysis Laboratory at the Université du Québec à Montréal to trace the media coverage of health inequalities in Canada over the year 2008, which was a banner year for events and publications with health inequalities as their central theme. We traced this coverage in part to determine whether increased media coverage would contribute to policy change as one approach - punctuated equilibrium theory - suggests. Certainly in at least one case the high media/public profile of reports detailing socioeconomically based health inequalities went on to be used to garner public and governmental (if not financial) support for a community-based enterprise which will attempt to alleviate food insecurity (among other things) in Saskatoon's low income neighbourhoods.
Another ongoing project is an attempt to use the concept of “wicked problems” to explore ways that this approach might address the full complexity of the causes of health inequalities as well as the multipronged and multisectoral fields where intervention is required. Other avenues for exploring the question of health inequalities at the Centre include looking at how these are related to specific public policies and to the policy field more generally.
Currently, the Centre is preparing fact sheets on wicked problems and the approaches which best attempt to resolve them. Additionally, staff at the Centre are pursuing workshops and seminars on Dialogue Mapping™ in an attempt to bring this approach to public health actors dealing with wicked problems.
Documenting anti-poverty initiatives
This project aims to share information about various Canadian anti-poverty initiatives with the public health community. We have documented the Quebec experience in terms of its strategy to combat poverty and social exclusion. The legislation passed in Quebec has received interest from the public health community as an example of healthy public policy. We have also documented comprehensive policies to combat poverty across Canada by province in order to familiarize public health actors with concrete measures that individual provinces have taken to reduce poverty.
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