By Martha Traverso-Yepez
In addition to Canadians’ opinions on health care, the 12th Canadian Annual National Report Card published by the Canadian Medical Association brings important insights on how the social, cultural and economic environment has a relevant influence on citizens’ health.
This year, the poll included questions about health status, knowledge and awareness of how to be healthy, as well as about lifestyles as related to health. Demographic questions were also added to account for the social determinants of health.
The document demonstrates that health is not something we simply obtain at the doctor’s office. Health starts in our families, through positive early experiences in childhood and healthy public policies to guarantee quality early care and education. It is produced in our schools, playgrounds and parks, where positive development is a priority and every child has the opportunity to develop their potential no matter what the family background is. It is dependent on the current economy, where jobs and living wages should be guaranteed, as well as on a positive work environment, which allows creativity and sense of control. Finally, health is framed in all our social and physical environments, where there is awareness about the close relationship between positive, nurturing spaces and citizens’ healthy choices and lifestyles.
The poll shows that income and education significantly impact people’s health assessments and their use of health care services. Canadians with lower incomes (less than $30,000 a year or 30K) report far poorer health than those with incomes of 60K or more (in a rate of 39 per cent against 68 per cent respectively), despite accessing health-care services more frequently than those with higher income (59 per cent against 43 per cent).
On all key health categories in the survey (worried about health, diagnosed with a chronic condition, eating five servings of vegetables daily, sleeping six to eight hours a night, describing diet as well balanced and healthy, or very/somewhat physically active), the 60K or more group scores much better than the less than 30K group.
Moreover, on some relevant health issues, such as being overweight, having overweight children, using tobacco on a daily basis and eating three meals every day, not only did the 60K or more group scores better, but the income gap widens as compared with the results from the 2009 survey, where similar questions were asked. For example, the difference between the two groups in the daily use of tobacco was only 12 per cent in 2009, while currently it is 23 per cent, demonstrating how the health promotion campaigns are more likely to have a positive impact on those with better income and living conditions.
While in 2009 there was no difference between both groups regarding the access of health care, the gap between the two groups is now 16 per cent. Those with the lowest income also had a higher reported percentage of being diagnosed with a chronic condition during the last month (41 per cent against 28 per cent among those with 60K or more).
It is time to realize that health has to be fostered through healthy public policies to guarantee jobs, fair wages and positive work environments; to provide families with time and the necessary resources to play with their children at the end of a working day; to enhance positive social networks, where citizens have opportunities to relieve stress and develop their potential to contribute to their community’s well-being.
The CMA National Report card confirms that, as important as it is to guarantee that every citizen has access to quality health care, it is crucial to think on the prerequisites of health, so that people are less likely to require these services in the first place.
Martha Traverso-Yepez is a faculty member
in the division of community health and humanities at MUN.