Poorest Canadians more likely to enter hospital: report

From EndCanadianPoverty.ca

• Date: November 24, 2008
• Source: CBC News
• Link to article: Poorest Canadians more likely to enter hospital: report

"Poorer Canadians are more likely to enter hospital for health problems such as child asthma, mental illness and diabetes, including potentially preventable conditions, according to a report released Monday.

The study by the Canadian Institute for Health Information, called Reducing Gaps in Health: A Focus on Socio-Economic Status in Urban Canada, compared hospitalization rates for various illnesses in the country's 15 largest urban areas, representing two-thirds of the urban population.

Urban Canadians in lowest socio-economic groups, based on income, education and employment, were more likely to be hospitalized for chronic conditions that could be treated in the community, the study's authors found for the three-year period between 2003 and 2006.

The gaps are important partly because it is costlier to the public-health system to treat people in hospital than in the community.

For example, after factoring out age in all cases:

• Children from low socio-economic groups had 56 per cent higher hospitalization rates for asthma than children from high socio-economic groups (233 per 100,000 people in the low group compared with 149 per 100,000 in the high group).
• People from lower-income groups were 2.4 times more likely to be hospitalized for diabetes than those in wealthiest group (102 per 100,000 in the low socio-economic group compared with 43 per 100,000 in the high socio-economic group).
• Among people with mental illness, hospitalization rates were 2.3 times higher for those in the low-socioeconomic group compared with the high group (596 per 100,000 people compared to 256 per 100,000).

"Knowing where the health gaps are widest can help those of us on the front lines better address the underlying reasons those gaps exist," said Dr. Cordell Neudorf, chair of the Canadian Population Health Initiative Council and chief medical officer of health for the Saskatoon Health Region.

Where the gaps are small, universal programs may be more successful, but large gaps may require targeted programs, Neudorf said. Canadian policies aim to reduce rates of low income among seniors and children, the report's authors noted.

To close gaps such as the higher rates of Type 2 diabetes and tuberculosis among aboriginal Canadians, native leaders and international public health experts have called for targeted programs to address overcrowded housing and poorer nutrition in First Nations communities. Smaller gaps for obesity rates

Of the 15 urban areas examined in the study, Regina and Winnipeg had the most profound differences in hospitalization rates of people in different socio-economic groups, while Ottawa–Gatineau and Toronto showed more consistent rates across the three income groups, the report's authors said.

Hospitalization rates for mental illness among the poorest people living in Regina, for example, were about 4.5 times that of the wealthiest group, while the gap was 2.0 times between the same income groups in Ottawa-Gatineau.

The report's authors found gaps were smaller for low birth weight babies (6.9 per 100 live births in the low socioeconomic group versus 5.6 per 100 live births in the high socio-economic group) and hospitalization for injuries in children (330 per 100,000 versus 274 per 100,000).

In terms of self-reported health, 30 per cent of poorer Canadians said they smoked compared with 17 per cent in the high socio-economic group.

There were virtually no gaps between the income groups for rates of influenza immunization among seniors (63 per cent in the low group compared with 68 per cent in the high group), and being overweight or obese (48 per cent versus 44 per cent).

The report included interactive Google Earth maps to visualize how the study divided socio-economic groups within urban areas."