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Health Policy. 2016 Sep;120(9):1040-50. doi: 10.1016/j.healthpol.2016.07.019. Epub 2016 Aug 3.

Socioeconomic gradient in health in Canada: Is the gap widening or narrowing?

Author information

1
School of Health Administration, Faculty of Health Professions, Dalhousie University, 5161 George Street, Suite 700, Halifax, NS B3J 1M7, Canada. Electronic address: m.hajizadeh@dal.ca.
2
Geriatric Medicine Research, Faculty of Medicine, Dalhousie University, Canada.

Abstract

BACKGROUND:

Notwithstanding a general improvement in health status, the socioeconomic gradient in health remains a public health challenge worldwide.

OBJECTIVE:

Using longitudinal data from the National Population Health Survey (NPHS, n=17,276), we examined trends in socioeconomic gradients in two health indicators, viz. the Health Utility Index (HUI) and the Frailty Index (FI), among Canadian adults (25 years and older) between 1998/9-2010/11.

METHODS:

The relative and slope indices of inequality (RII and SII, respectively) were employed to summarize income- and education-based inequality in the FI and the HUI in Canada as whole, and in five regions: the Atlantic provinces, Quebec, Ontario, the Prairies and British Columbia.

RESULTS:

We found that education- and income-related inequalities in health were present in all five regions of Canada. The estimated RIIs and SIIs suggested that education-related inequalities in the FI and the HUI increased among women. The results also revealed that relative and absolute income-related inequalities in the HUI increased in Canada, especially among women. Both absolute and relative inequalities indicated that income-related inequalities in the HUI increased in Quebec and in the Prairies over time.

CONCLUSION:

Persistent and growing socioeconomic inequalities in health in Canada over the past one and half decades should warrant more attention. The mechanisms underlying socioeconomic-related inequalities in Canada are less clear. Therefore, further studies are required to identify effective polices to reduce the socioeconomic gradient in health in Canada.

KEYWORDS:

Canada; Education; Frailty Index; Health Utility Index; Income; Socioeconomic inequalities

PMID:
27523425
DOI:
10.1016/j.healthpol.2016.07.019
[Indexed for MEDLINE]

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