Canadian Institute for Health Information report shows how poverty contributes to poor health

New report from The Canadian Institute for Health Information (CIHI)

Canadians in Lower Socio-economic Groups More Likely To Be Hospitalized for Mental Illness, Child Asthma - New CIHI study examines health differences in 15 urban areas in Canada; finds gaps wider in some areas than others.

November 24, 2008—In major urban areas across Canada the situation is similar: the lower your socio-economic status, the more likely you are to be hospitalized for any number of health issues, from childhood asthma to mental illness to diabetes. A new study from the Canadian Institute for Health Information (CIHI) is the largest of its kind to examine differences in health and health system use between Canadians in high-, average- and low-socio-economic status groups.

Reducing Gaps in Health: A Focus on Socio-Economic Status in Urban Canada compares 21 health-related indicators between three socio-economic status groups—low, average and high—within and across 15 of Canada’s largest census metropolitan areas, representing 66% of Canada’s urban population as defined by CIHI analyses. Socio-economic status (SES) is a measure of an individual’s economic and social position relative to others, based on income, education and employment.

CIHI’s study examined hospitalization rates for different types of admissions (such as for injuries and anxiety disorders) over a three-year period (between 2003–2004 and 2005–2006) and found the effects of SES were more noticeable for some types of admissions than for others. For example:

  • Hospitalization rates for mental illness in the low-SES group were 2.3 times those in the high-SES group (596 per 100,000 people compared to 256 per 100,000). Hospitalization rates for substance-related disorders in the low-SES group were 3.4 times those in the high-SES group.
  • Urban Canadians in low-SES groups were more than twice as likely to be hospitalized for chronic conditions that could potentially be treated in the community, known as ambulatory care sensitive conditions. For example, they were 2.4 times more likely to be hospitalized for diabetes and 2.7 times more likely to be hospitalized for chronic obstructive pulmonary disease.
  • Children from low-SES groups had 56% higher hospitalization rates for asthma than children from high-SES groups.
  • Gaps were less pronounced, however, for low-birth-weight babies and hospitalizations for injuries in children.

“Knowing where the health gaps are widest can help those of us on the front lines better address the underlying reasons those gaps exist,” says Dr. Cordell Neudorf, Chair of the Canadian Population Health Initiative (CPHI) Council and Chief Medical Officer of Health for the Saskatoon Health Region. “Where there are small differences in health status between socio-economic groups, universal programs aimed at the general population may be more successful, but when there are large gaps, these concerns may require more targeted programs tailored for specific groups.”

CIHI’s study also looked at differences in self-reported health status. Using Statistics Canada’s Canadian Community Health Survey, the study found Canadians in low-SES groups were nearly twice as likely to report smoking as those in high-SES groups. However, there were only small gaps between groups for rates of influenza immunization, alcohol binging or being overweight or obese.

“Today’s study reveals new information on the effect income, education and employment status may have on hospitalization rates across the country,” says Jean Harvey, Director of CPHI, a program of CIHI. “Canadians with lower socio-economic status are more likely to be hospitalized for conditions like mental illness and other chronic diseases, conditions that might potentially be prevented or treated in the community.”

Health status across 15 urban areas in Canada varies
The health status of the urban population in Canada varies within and across urban areas, as do the gaps between socio-economic groups. Of the 15 urban areas examined in this study, Regina and Winnipeg had the most profound differences in hospitalization rates of people in different socio-economic groups, while Ottawa–Gatineau and Toronto had the least, with more consistent rates across the three levels of SES. For example, hospitalization rates for mental illness in the low-SES group in Regina were about 4.5 times that of the high-SES group. In Ottawa–Gatineau, the mental health hospitalization rates for those in the low-SES group were 2.0 times those in the high-SES group.

For self-reported health, residents in Halifax and St. John’s were the most likely to report similar health status, regardless of SES group, while Victoria and London had the greatest gaps between SES groups.

About this report
This report was prepared by CIHI’s Canadian Population Health Initiative in collaboration with CIHI’s Health Indicators department, the Urban Public Health Network, the Institut national de santé publique du Québec and Statistics Canada.

About CPHI
The Canadian Population Health Initiative (CPHI) is part of the Canadian Institute for Health Information (CIHI). CPHI conducts and supports research to foster a better understanding of factors that affect the health of individuals and communities; and to contribute to the development of policies that reduce inequities and improve the health and well-being of Canadians.

About CIHI
The Canadian Institute for Health Information (CIHI) collects and analyzes information on health and health care in Canada and makes it publicly available. Canada’s federal, provincial and territorial governments created CIHI as a not-for-profit, independent organization dedicated to forging a common approach to Canadian health information. CIHI’s goal: to provide timely, accurate and comparable information. CIHI’s data and reports inform health policies, support the effective delivery of health services and raise awareness among Canadians of the factors that contribute to good health.

Media contacts:

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Jennie Hoekstra
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Reducing Gaps in Health: A Focus on Socio-Economic Status in Urban Canada
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