Abstract
The first annual report of the Chief Public Health Officer on the State of Public Health in Canada draws notable attention to health inequalities in Canada. This report provides a compelling presentation of our current health status and the uneven distribution of health across the population, noting persistent and sizeable gaps in life expectancy, infant mortality, self-reported health, prevalence of chronic diseases, and other health indicators between higher- and lower-income groups, as well as the extraordinary disadvantage experienced by Canada’s Aboriginal peoples. However, the report falls short of offering a critical approach to addressing and reducing health inequalities. It fails to stimulate thinking about integrated strategies by profiling current responses that do little to address the underlying structural drivers of health inequalities and ignoring the population health framework’s recognition of the complex interactions among the determinants of health. Despite its shortcomings, the report shines a light on major health inequalities in Canada, providing a foundation for further action. Public health workers in this country must build on this foundation, working together and with all sectors and levels of government to identify and implement integrated strategies to reduce health inequalities and inequities in Canada.
Key words: Health inequalities, health inequities, population health, social inequalities, Chief Public Health Officer
Résumé
Le premier rapport annuel de l’administrateur en chef de la santé publique sur l’état de la santé publique au Canada a attiré l’attention sur les inégalités notables en matière de santé au Canada. Ce rapport présente de façon convaincante l’état de santé actuel et la distribution irrégulière de la santé parmi la population, indiquant les lacunes constantes et assez considérables en matière d’indicateurs pour l’espérance de vie, la mortalité infantile, l’état de santé déclaré, la prévalence des maladies chroniques, et autres indicateurs sur la santé entre les groupes à revenu plus élevé et les groupes à plus faible revenu, ainsi que le désavantage extraordinaire que connaissent les Autochtones. Toutefois, le rapport n’offre pas une approche critique pour traiter et réduire les inégalités en matière de santé. Il ne stimule pas la réflexion sur des stratégies intégrées en définissant les réactions actuelles qui n’aident que très peu à traiter les facteurs structurels des inégalités relatives à la santé et ne tient pas compte de la reconnaissance des interactions complexes du cadre de santé de la population parmi les déterminants de la santé. Malgré ses lacunes, le rapport met en lumière les principales inégalités relatives à la santé au Canada, fournissant ainsi un fondement pour d’autres mesures. Les travailleurs du réseau de la santé publique de ce pays doivent miser sur ce fondement, travailler ensemble et avec tous les secteurs et ordres de gouvernement afin de déterminer et de mettre en oeuvre des stratégies intégrées pour réduire les inégalités et les iniquités au Canada.
Mots clés: inégalités en matière de santé, santé de la population, inégalités sociales, administrateur en chef de la santé publique
Footnotes
Acknowledgements: Sharon Kirkpatrick receives financial support from an Alberta Heritage Foundation for Medical Research Post-Doctoral Fellowship. Lynn McIntyre receives financial support as CIHR Chair in Gender and Health.
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