Richer, poorer: In sickness and in health

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Technical report: Trends in Income-Related Health Inequalities in Canada: Technical Report

Summary report: Trends in Income-Related Health Inequalities in Canada: Summary Report

eTool: Health Inequalities Interactive Tool

Data tables: Trends in Income-Related Health Inequalities in Canada: Data Tables

Gallery: Infographics

November 18, 2015 — Canada has made little progress in closing the gap between the health of richer and poorer Canadians, according to data released today by the Canadian Institute for Health Information (CIHI). In fact, this gap has generally persisted or widened over time.

To compare the health of richer and poorer Canadians, CIHI divided the population into 5 equal groups based on their income and measured indicator rates over time. "The magnitude of the inequality between the health of richer Canadians and poorer Canadians is significant across the majority of the indicators we reviewed," said Kathleen Morris, CIHI's vice president of Research and Analysis. "Over the past decade, inequalities did not change for 11 of the 16 indicators CIHI studied; in other words, the health of the poorest Canadians in relation to that of the richest is not getting better."

CIHI looked at a number of important factors over time, including income and factors influencing health, such as access to housing and food, and rates of smoking and obesity. CIHI also examined rates of injury, chronic disease and other areas.

For 3 indicators, the gap between rich and poor has widened over time:

  • Smoking — Adults in the highest income level smoked less over time, but there was no change among Canadian adults in the lowest income level.
  • Chronic Obstructive Pulmonary Disease (COPD) Hospitalization for Canadians Younger Than Age 75 — Rates decreased for the highest income level but increased for lower-income Canadians.
  • Self-Rated Mental Health — The percentage of adults who rated their mental health as "fair" or "poor" increased over time in all income levels, except the highest.

These inequalities are associated with significant costs, both to individuals and to society, through direct health care costs and indirect costs such as lost productivity. For example, if all Canadians experienced the same low rates of hospitalization for COPD as the highest income earners, there would be more than 18,000 fewer hospitalizations a year, which translates into $150 million in health-sector spending annually.

CIHI's Trends in Income-Related Health Inequalities in Canada project includes a technical report and summary report, as well as an electronic tool for more in-depth analysis. This work is a major contribution to national efforts to monitor health inequalities in Canada.

About CIHI

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 health information. CIHI’s data and reports inform health policies, support the effective delivery of health services and raise awareness about the factors that contribute to good health and health care.

For examples of how CIHI data is helping support quality care initiatives in featured health care facilities, see the most recent success stories on our YouTube channel.