Regional Differences in Prioritizing Determinants of Health: Ontario vs. British Columbia
- lydiaalemu1
- Oct 13, 2022
- 4 min read
According to Invest Ontario (2019), the Global Wellness Index ranked Canada as the best country to live in based on indicators that measure global health, wealth and happiness. Furthermore, the Conference Board of Canada (2015) lists British Columbia and Ontario as the top-rated provinces within Canada. British Columbia scored an “A” on the overall health report card followed by Ontario with a “B” grade. The chart below lists the health performance grades of all Canadian provinces using 11 health indicators.
Figure 1
Health Report Card
Note. Created by the Conference Board of Canada, 2015.
As seen from the chart above, though Canada is considered one of the healthiest countries to live in, every province faces their own health challenges. The Government of Canada (2022) states that the determinants of health encompass a broad range of personal, social, economic and environmental factors that determine the health of an individual or population. Whereas social determinants of health refer to a specific group of social and economic factors within these broader determinants. More specifically, these relate to an individual's social group, income, education, and experiences of discrimination and historical trauma. The main determinants according to the Government of Canada (2022) are listed as follows;
1. Income and social status
2. Employment and working conditions;
3. Education and literacy;
4. Childhood experiences;
5. Physical environments;
6. Social supports and coping skills;
7. Healthy behaviours;
8. Access to health services;
9. Biology and genetic endowment;
10. Gender;
11. Culture; and
12. Race/Racism (Government of Canada, 2022).
Ontario is Canada's second largest province and is home to over 15 million people from various cultural and ethnic backgrounds (About Ontario, 2012). However, despite living in the same province different individuals and populations have their own unique experience with the social determinants of health. Over the last two years, Ontario's health care system has been facing an ever-growing crisis; staffing shortages, increased wait times, reduced quality of care and lack of accessibility has resulted in poorer health outcomes for individuals and populations seeking out health services. Ontario Health's Annual Business Plan for 2022-2023, set out strategic priorities in response to the COVID-19 pandemic. These priorities aim to:
1. Reducing health inequities;
2. Transform care with the person at the centre;
3. Enhance clinical care and service excellence;
4. Maximize system value by applying evidence; and
5. Strengthen Ontario Health's ability to lead.
This business plan also includes collaboration with Indigenous communities and partners to improve health outcomes, as well as the Black community to reduce health inequities and address anti-black racism in healthcare interactions (Ontario Health, 2022). Alongside the resources offered on the Government of Canada website, the Government of Ontario and Ontario Health both offer websites with various resources discussing disease prevention, infection control, the development of health care standards, and other strategic health mandates.
British Columbia is Canada's most western province and is home to a population of over 5 million people as of April 1st, 2022 (Government of B.C., 2022). According to the statistics provided by "Welcome B.C." (n.d.) almost 30 percent of the population immigrated from another country and another five percent of the population is Indigenous. Despite British Columbia's high health rank, "BC Alliance for Healthy Living" (n.d.) states that Indigenous peoples, immigrants, those of lower income or those experiencing mental health issues are more likely to have negative health outcomes. Presently, British Columbia is still experiencing an opioid overdose and homelessness crisis. In 2017 the province established an Overdose Emergency Response Centre (OERC) to provide support to health authorities and First Nations governments. The province also created programs like the Homeless Community Action Grant in 2019 that allows communities and non-profits to increase their capacity to respond to homelessness and improve population outcomes (Province of British Columbia, 2021).
The Province of British Columbia (2021) has established the "Standard" to assist health care providers in identifying and understanding the social determinants of health, and the resulting impact on individuals and populations. This standard is used for the consistency in data collection about an individuals;
1. Cultural identity and immigration status;
2. Indigenous identity;
3. Socio-economic status;
4. Housing insecurity;
5. Food insecurity;
6. Occupation and employment including higher risk work history;
7. Language; and
8. Social capital/adhesion (Province of British Columbia, 2021).
In turn, the Standard supports the delivery of culturally safe health care and positive health outcomes for individuals and populations facing health inequities (Province of British Columbia, 2021). The Government of British Columbia's website offers health resources, British Columbia Centre for Disease Control provides health information on disease risks, and Health Link BC also offers various resources on building healthy lifestyles, mental health, substance abuse, testing and treatment.
References
About Ontario. ontario.ca. (2012, September 4). Retrieved October 13, 2022, from
https://www.ontario.ca/page/about-ontario
Annual business plan 2022-23 - Ontario Health. Ontario Health. (n.d.). Retrieved October 13, 2022, from
https://www.ontariohealth.ca/sites/ontariohealth/files/2022-05/OHBusinessPlan22_23.pdf
BC Centre for Disease Control. (n.d.). Retrieved October 13, 2022, from http://www.bccdc.ca/
Canada named Healthiest Country in the world. Invest Ontario. (2019, April 8). Retrieved October
13, 2022, from https://www.investontario.ca/spotlights/canada-named-healthiest-country-
world#related
Canada, P. H. A. of. (2022, June 14). Government of Canada. Social determinants of health and health
inequalities - Canada.ca. Retrieved October 5, 2022, from https://www.canada.ca/en/public-
health/services/health-promotion/population-health/what-determines-health.html
Government of ontario. ontario.ca. (n.d.). Retrieved October 13, 2022, from
https://www.ontario.ca/page/government-ontario
Health inequities. BC Healthy Living Alliance. (2022, August 11). Retrieved October 13, 2022, from
https://www.bchealthyliving.ca/healthy-living/health
inequities/#:~:text=BC%20data%20shows%20that%20Indigenous,likely%20to%20have
%20poorer%20health
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