Hinnovic » For a healthier Canada, a seismic shift is needed

For a healthier Canada, a seismic shift is needed

For a healthier Canada, a seismic shift is neededThis is our 200th Post!A report recently released by the Health Council of Canada declares that unless governments change their approach to addressing the needs of poorer and socially disadvantaged Canadians, we are destined to continue to paying handsomely for the consequent demands on our health care system.


Making an impact on the underlying determinants of health will require governments to think and work differently.


The report Stepping It Up: Moving the Focus from Health Care in Canada to a Healthier Canada indicates that health disparities play a significant role in health system costs. It states that ongoing spending on acute care and programs encouraging a healthy lifestyle are not enough to improve the overall health of Canadians, particularly those who live in or close to poverty.




A few highlights from the report:

  • Many factors beyond the health care system have a strong impact on health: our income, our level of education, what kind of work we do, our relationships, our early childhood experiences, the safety and quality of our housing and communities, and other environmental factors.

  • Health care spending is expected to reach $192 billion in 2010. An estimated 20% of total health care spending may be attributable to income disparities.

  • The rates of diabetes and heart disease among the poorest 20% of the population are more than double the rates of the richest 20% of the population.

  • Low income people are twice as likely to use healthcare services as those with the highest incomes.

  • A Saskatoon study found that low income residents consume 35% more health care resources than middle and high income residents.

  • A Winnipeg study found that eliminating the gap between the poorest and wealthiest neighbourhoods would reduce heart attacks by 22% and hip fractures by 20%.

  • The poverty rate in Canada is estimated at 11%, with rates being much higher for specific sectors of society lone-parent families (26%), work-limited people (21%), recent immigrants (19%), and off-reserve Aboriginal people (17%).




Intersectoral CollaborationWhile knowledge of the determinants of health and their impact on health care spending is not new, the report goes further to address a key factor in proactive responses: intersectoral collaboration. Otherwise known as “whole-of-government”, “whole-of-society” or “joined-up” approaches in Europe, the notion is that significant progress on addressing fundamental determinants of health like the income (and health) gap between rich and poor requires government departments and organizations to be working together.


Most significantly, key informants with a wealth of experience at various levels of government were canvassed for the report and offer sanguine advice and insights on how to move forward on intersectoral action for health. This is perhaps the strongest contribution of the report, as it moves from underscoring the importance of determinants of health and the need for intersectoral collaboration to how to best move this agenda forward in the current political context, drawing strategically for examples of success across the country and internationally.


The report underscores how politicians and governments need to reconsider how they think about health, calling for a better balance between investing in an acute care system and investing in the factors that materially affect our health. “Governments need to govern more collaboratively, in an approach that links multiple ministries, multiple levels of government, and other sectors of our society”, says John G. Abbott, CEO of the Health Council of Canada.


To read commentary from guest bloggers and other health industry leaders about health promotion in Canada or to download the full report visit:



Created by the 2003 First Ministers’ Accord on Health Care Renewal, the Health Council of Canada is an independent national agency that reports on the progress of health care renewal in Canada. The Council provides a system-wide perspective on health care reform in Canada, and disseminates information on best practices and innovation across the country. The Councilors are appointed by the participating provincial and territorial governments and the Government of Canada.



For more on the determinants of health, have a look at our
Social Inequalities in Health dossier.

Author : Blake Poland, Ph.D.
Dalla Lana School of Public Health
University of Toronto
Member of the HCC Expert Panel for Stepping Up


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