Health Determinants and Inequality

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Questions and Answers

What influences a person's socioeconomic position according to the structural determinants?

Societal, economic, and political context (correct)

Personal lifestyle choices

Health awareness and education levels

Genetic predisposition

Which of the following is NOT considered an intermediary determinant of health?

Psychosocial factors

Material circumstances

Social class (correct)

Biological factors

Which factors are included in the socioeconomic position?

Political affiliations and social circles

Genetic traits and environmental exposure

Lifestyle habits and diets

Social class, gender, ethnicity, education, occupation, and income (correct)

How can social cohesion and social capital influence health outcomes?

By creating policies and structures that improve health equity Signup and view all the answers

Which aspect of health determinants emphasizes that most factors are beyond individual control?

Social determinants of health Signup and view all the answers

What percentage of healthcare spending in Canada comes from public funding?

70% Signup and view all the answers

Which category accounts for the highest percentage of healthcare spending in Canada?

Hospitals Signup and view all the answers

Which of the following best describes Canada's healthcare system?

Publicly financed and privately delivered Signup and view all the answers

What major issue did the Lalonde Report identify regarding health outcomes?

Sick care model not helping marginalized people Signup and view all the answers

What is the purpose of the Canada Health Transfer?

To ensure provinces follow the rules of the Canada Health Act Signup and view all the answers

According to the Canada Health Act, healthcare services are provided based on what criteria?

Need Signup and view all the answers

Which historical figure is associated with the establishment of public universal hospital insurance in Canada?

Tommy Douglas Signup and view all the answers

Why is primary healthcare considered the most cost-effective method to ensure healthcare access?

It focuses on preventing illness rather than treating it. Signup and view all the answers

What is the primary consequence of job insecurity on health outcomes?

Poorer health outcomes Signup and view all the answers

Which population is more likely to suffer from worse health outcomes according to income levels?

Lower income children Signup and view all the answers

Which model suggests that living conditions have a direct influence on health?

Materialist model Signup and view all the answers

What type of effect involves experiences from early life impacting future behaviors?

Latent effect Signup and view all the answers

Which of the following statements describes a cumulative effect in health outcomes?

Long-term disadvantages can continue to affect individuals even after positive changes. Signup and view all the answers

Which country model is recognized for effectively closing the income gap and improving public health outcomes?

Nordic countries model Signup and view all the answers

Income is suggested to be a better marker for life circumstances than which of the following?

Tobacco use Signup and view all the answers

What does the materialist model view as a significant influence on health outcomes?

Living conditions and experiences Signup and view all the answers

Which group has a significant representation among the shelter population in Toronto?

Indigenous individuals Signup and view all the answers

What is one of the reasons older adults may face poverty in retirement?

Lack of employer pension plans Signup and view all the answers

Which measurement tool is used to assess basic living costs including shelter and food?

Market Basket Measure (MBM) Signup and view all the answers

How does the Absolute Income Hypothesis relate income to health?

Income has no impact on health after a certain threshold. Signup and view all the answers

What is a common contributing factor to poverty among racialized children?

Systemic barriers such as racism Signup and view all the answers

What does high decision latitude allow an individual to do?

Develop and implement potential solutions Signup and view all the answers

Which definition best describes absolute poverty?

Having less than the objectively defined minimum - life-threatening Signup and view all the answers

What does relative poverty signify?

Having significantly less than the general population Signup and view all the answers

Which statement about median income is accurate?

Median income provides a more accurate reflection of central tendency. Signup and view all the answers

What is meant by the social gradient in health?

Health status improves as one moves up the social hierarchy. Signup and view all the answers

Which group is most likely to experience poverty?

Unattached individuals with limited resources Signup and view all the answers

What is the primary concern with wealth distribution globally?

A significant portion of wealth is concentrated in a small percentage of the population. Signup and view all the answers

What effect do clawbacks have on government support programs?

They reduce benefits as individuals earn more, impacting financial stability. Signup and view all the answers

Study Notes

Structural Determinants

Structural determinants of health include the societal, economic, and political context in which a person lives.
These determinants influence a person's socioeconomic position
These include social class, gender, ethnicity, education, occupation, and income.

### Socioeconomic Determinants

Socioeconomic position feeds into intermediary determinants.
Intermediary determinants include material circumstances, biological and behavioral factors, and psychosocial factors.
Intermediary determinants influence health equity and wellbeing.

### Social Cohesion and Social Capital

Social cohesion and social capital can bridge structural determinants and health outcomes.
Policies and structures influence health outcomes for individuals.

Income Inequality and Health

A small proportion of the population holds a high concentration of income, while the rest has a small percentage.
Income inequality is associated with poorer health outcomes.
Job insecurity contributes to poorer health and reduced control over one's environment, leading to a shorter life expectancy.
Compared to North America, Nordic countries' public policies focus on closing the income gap, leading to better population-wide health outcomes.

### Models of Social Determinants of Health

The materialist model of social determinants of health suggests living conditions influence socioeconomic determinants of health, which in turn influence health outcomes.
Material living conditions, experience of psychological stress, adoption of health-supporting or threatening behaviors, income potential, and health capital all contribute to individual health.
Income potential is linked to education and accumulated childhood experiences, which shape future job opportunities.
Health capital encompasses childhood experiences and influences access to healthcare in the future.

### Life Course Model of Social Determinants of Health

The life course model suggests latent, pathway, and cumulative effects influence health over a person's lifetime.
Latent effects are generally genetic or occur early in life, such as maternal addiction during pregnancy influencing a child's susceptibility to drug dependence.
Pathway effects describe different paths individuals take throughout life, where positive experiences contribute to better outcomes, such as enrolling in private school compared to public school.
Cumulative effects refer to the accumulation of advantages or disadvantages throughout someone's life. Even if an individual escapes a poor situation, these effects often persist.

### Public Funding and Healthcare

Public funding accounts for 70% of healthcare spending.
Canada's healthcare is publicly financed and privately delivered.
The largest healthcare expenditures are for hospitals followed by drugs and then physicians.
The cost of healthcare can push people into poverty.
Universal healthcare (UHC) removes the financial burden associated with healthcare costs.
PHC investment represents the most cost-effective way to ensure access to essential healthcare.

### Historical Impacts on Canada's Healthcare System

Saskatchewan, in 1947, established the first public universal hospital insurance.
The Lalonde Report (1974) identified the lack of health outcomes for marginalized people.
The Lalonde Report also highlighted the limitations of treating people only when they were sick, emphasizing the need for a focus on prevention.
It was the first formal document linking health with social determinants.
Emmet Hall recognized the issue of a two-tiered healthcare system where poor people could not afford proper healthcare.

### Canada Health Act

The Canada Health Act is a federal document for publicly funded healthcare insurance.
It mandates healthcare based on need, irrespective of the ability to pay.
The Canada Health Act is based on five criteria: universality, portability, accessibility, comprehensiveness, and public administration.
Healthcare in Canada is not "free."
The funding for healthcare comes from provincial and federal taxes, as well as private insurance purchases.
Federal government funding through the Canada Health Transfer provides healthcare services to priority populations.
The Canada Health Transfer gives money to the provinces and territories that adhere to the Canada Health Act's principles.
Non-compliance with the Canada Health Act leads to funding cuts from the Canada Health Transfer to the provinces.

### Income and Wealth

Income encompasses earnings, including market income and government transfers.
Wealth refers to assets minus debt.
The Low-income cut-off (LICO) is the point at which families or individuals spend 20% or more on food, shelter, and clothing compared to the average family or individual in a particular location.
Decision latitude refers to the degree of control an individual has over their work and decision-making.
High decision latitude implies greater empowerment to develop and implement solutions.
Low decision latitude signifies limited choices and restricted options.
Market income encompasses employment and pension income.
The top 20% of Canadian families own almost 50% of market income.

### Poverty

Poverty refers to the state of being deprived of resources, means, choices, and power, hindering the acquisition and maintenance of a basic standard of living.
It is a lack of power and choice that prevents participation in society.
Relative poverty refers to having significantly less compared to the prevalent population.
Absolute poverty involves having less than a predetermined minimum standard, potentially life-threatening.
Self-determination involves an individual's control over their own life.
Social class refers to a group of people with similar backgrounds, incomes, and lifestyles.
The social gradient emphasizes the poorest individuals worldwide have the worst health, highlighting the correlation between health status and social inequalities.

### Income Statistics

The median income is a more accurate representation of the middle, as it is less influenced by extreme values compared to the mean income.
The inclusion of high earners, such as Bill Gates, drastically increases the mean income.
Be mindful of potential distortions when interpreting economic data.
The wealthiest 8.6% control 86% of global wealth.

### Income Assistance Programs

Income assistance programs like Ontario Works (OW) and Ontario Disability Support Program (OSDP) may have clawbacks.
Clawbacks can deduct 50 cents for every dollar earned if income surpasses $200 per month.

### Poverty Demographics

The hardest-hit populations for poverty are women and children, older adults, people experiencing homelessness, and racialized individuals.
Women and children are disproportionately represented among the poor due to factors such as single-parent households, lower wages, and gender discrimination.
Older adults often lack employer-sponsored pension plans and face higher medical bills and prescription costs.
Many carry debt into retirement and may be forced to re-enter the workforce under precarious conditions.
People experiencing homelessness have the lowest life expectancies and almost all are living below the LICO.
Racialized individuals face systemic barriers, including racism, which hinders employment opportunities.
28-34% of the shelter population is Indigenous, despite their smaller population size.
40% of residents in Toronto city shelters are refugees or asylum seekers.
Racialized children are more likely to live in poverty than white children.

### Addressing Poverty

The Child Tax Benefit has helped alleviate some poverty rates, but its impact varies based on whether the LIM-AT (12%) or MBM (9%) metric is considered.
It notably did not include First Nations communities, potentially underestimating the true extent of poverty reduction.
The MBM measures essential goods for everyday living, and the inclusion of Indigenous peoples in the MBM should be explored.
The Absolute Income Hypothesis proposes a positive, non-linear relationship between personal income and health.
It suggests that individuals experience minimal health gains when their income drops below a certain threshold.

### Income Inequality and Health

The income inequality and health relationship suggests rising disparities between the affluent and less fortunate contribute to underinvestment in social capital.

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Description

Explore the various structural and socioeconomic determinants that impact health outcomes. This quiz covers topics such as social cohesion, income inequality, and their effects on wellbeing. Understand how these factors contribute to disparities in health equity.