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Poverty as a Determinant of Health

It is widely acknowledged that health and social status are intimately related such that individuals in higher social classes are healthier and live longer than those in lower classes. This is true regardless of whether income, education or another socioeconomic indicator is used and regardless of the health outcome used.[1] Health improves with each increment in social class. So it is not only the most disadvantaged members of a society that experience poor health, but rather health status decreases with each step down the socioeconomic ladder, thus affecting the health of the entire population.[4]

Consider the following. These are only a few examples of the many ways in which income status impacts negatively upon health.

  • The risk of depression increases with decreasing income. For women, 13% in the lowest income group reported depression compared with 5% of women in the highest income group.[2]

  • Women with lower incomes who seek help for mental health issues are more likely to receive medication rather than psychotherapy, leaving them with the same stresses and little social support.[1]

  • Canadian men in the highest income quintile live on average 6.3 years longer and 14.3 more years without disability then men in the lowest income quintile.[2]

  • The infant mortality rate in Canada is 5.8 per 1000 live births. However, this rates is 5.0 in the highest income group, and 7.5 in the lowest income group.[2]

  • Lower income Canadians are more likely to report having seen a physician in the previous year, but are more likely to report unmet health care needs.[2]

In the remainder of the module, we will explore these and the many other impacts of poverty on health. It is important to keep in mind that the relationship between poverty and health is complex, and that not only does poverty contribute to poor health, but poor health may contribute to poverty. This issue will also be addressed elsewhere in the module.

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1. Canadian Public Health Association. Board of Directors Discussion Paper. Health impacts of social and economic conditions: Implications for public policy. 2001. Ottawa, Canadian Public Health Association.

2. Federal, Provincial and Territorial Advisory Committee on Population Health. Toward a healthy future: Second report on the health of Canadians. 1999

4. Donner, L. Women, income and health in Manitoba: An overview and ideas for action. 2002. Winnipeg, Women's Health Clinic.

All references for this section