Disadvantaged Populations Policies

Disadvantaged British Columbians have increased susceptibility to a broad range of chronic conditions and are more likely to be living with chronic illness. For example, the rate of diabetes among those with low incomes is double those with high incomes and for heart disease it is almost double. [i], [ii], [iii]

The evidence confirms that health inequities in BC are most pronounced among children and families living in poverty, the working poor, the unemployed/under-employed; those with limited education and/or low literacy, Aboriginal Peoples, new immigrants, persons suffering from social exclusion, the homeless and people with addictions and/or mental illness. [iv], [v], [vi], [vii]

In addition to the concentration of risk factors for chronic disease within these disadvantaged populations there are also cross-linkages between certain social conditions and specific groups. Population health data clearly shows that there is an active gradient (or slope) at work, as socio-economic status improves, so too do health outcomes. [viii], , [ix], [x]

BCAHL has reviewed the literature and sought expert opinion on what actions can be taken to address these health inequities in British Columbia so that this province can lead the way in healthy living for all citizens, particularly its most disadvantaged.

  • Support health promotion programs for specific populations, including low income populations, pregnant/breastfeeding women, the mentally ill, Aboriginal peoples and new Canadians.
  • First Nations in BC should be afforded more control over health, social, education and justice policies and funding that disproportionately affect Aboriginal peoples.
  •  All levels of government work with First Nations communities and educators to develop a plan to increase the rate of Aboriginal children graduating from high school to the same rates as non-Aboriginal children within ten years.
  • All levels of government work with First Nations communities and leaders to set measurable goals and create a plan for increasing Aboriginal representation in the workforce in terms of full-time employment, management positions and professional workplaces.
  •  Increase accessibility of language training programs to enable immigrants to learn English and for those with some English to increase their proficiency to levels that enable them to function effectively in the workplace, take courses at postsecondary institutions and/or enter into licensing programs.
  • Increase skills bridging programs to upgrade professional or technological skills and improve coordination between employers, apprenticeship bodies, licensing associations and service providers – making it easier for immigrant trades people and professionals to Canadianize their skills and credentials while also increasing opportunities to change careers.
  • Provide additional supports to settlement counsellors in order to improve their clients’ integration and chances for success in BC.
  • Ensure that the settlement of refugees includes the identification and treatment of mental health issues and support to overcome trauma experienced prior to immigrating to Canada.
  • Ensure the delivery of a comprehensive approach to prevention, promotion and early intervention – across the lifespan and across mental health/illness and addictions spectrums.
  • Develop a province wide seamless continuum of Mental Health care through cross-Ministry integration, improved information sharing systems and better integration of services.
  • Develop a long-term, consolidated, comprehensive, Interagency Social Housing System for hard to house individuals; including those living with mental health problems and addictions.

REFERENCES

[i]  Adapted from the Federal Provincial Territorial Advisory Committee on Population Health and Health Security. Reducing Health Disparities. Public Health Agency of Canada., 2007.

[ii] James R. et. al. The health of Canadians with diabetes. Health Reports.9(3). 1997.

[iii] Johansen, H. Living with Heart Disease: The Working Age Population. Statistics Canada: Health Reports. 10,1, 1999.

[iv>] Federal Provincial Territorial Advisory Committee on Population Health and Health Security. Reducing Health Disparities – Roles of the Health Sector: Recommended Policy Directions and Activities. Public Health Agency of Canada. ISBN: 0-662-69312-4., 2005.

[v] Frohlich K. Theoretical pathways to health disparities in Canada. Appendix 1. Report prepared for the FPT Advisory Committee on Population Health, 2003.

[vi] Federal Provincial Territorial Advisory Committee on Population Health. Toward a Healthier Future – Second Report on the Health of Canadians. Health Canada: 1999.

[vii] Canadian Institute for Health Information.  Improving the Health of Canadians, 2004. www.cihi.ca

[viii] Kerstetter, S. and Goldberg, M. A Review of Policy Options for Increasing Food Security and Income Security in British Columbia. Draft paper prepared for Provincial Health Services Authority, Vancouver, March, 2008.

[ix]World Health Organization Achieving Health Equity: From Root Causes to Fair Outcomes. 2007. W.H.O. Commission on the Social Determinants of Health.

[x] Public Health Agency of Canada. Addressing Health Disparities in Canada Through Intersectoral Action on the Determinants of Health. 2006.