L'équité en matière de santé : comment pouvons-nous favoriser le changement ?

Health equity is one of the biggest healthcare challenges in Canada and around the world. In 2021, the pandemic further exacerbated and highlighted not only the circumstances of those struggling with an inequitable system, but also the dangers of ignoring the fact that not everyone has the same access to care.

How do we define “health equity”?

The term “health equity” is broad, as this title has taken on vastly different definitions over the past decade. Public Health Ontario describes health equity as a healthcare system that reduces unjust and unfair differences which are avoidable. Differences that impact health equity include socio-economic factors such as education, income, race, ethnicity, gender, social status, and physical environment. However, the very common denominator of any definition for this term is the fact that true “health equity” can only be achieved when all individuals have a fair opportunity to reach their highest health potential.

What are some of the most prominent health equity barriers in Canada?

In a universal healthcare system like Canada’s, the principal expectation is that all Canadians have the same access to healthcare and receive the same treatment under our healthcare system.

Factors such as income, race, social status, and education have the strongest effects on health equity. Recent studies have also shown that on average, the lowest-income Canadians get 11.3 fewer healthy years throughout their lifetime than the highest-income Canadians. According to research conducted by BCG and CivicAction, Black women are three times less likely to have a family doctor than non-racialized women in Ontario. Recent research also revealed Indigenous Canadians have a harder time accessing healthcare than the average Canadian, with life expectancy for Métis people being 5-6 fewer years.

Meanwhile, low-income Canadians struggle to live a healthier lifestyle. People living in poverty are the most likely to suffer from obesity and malnutrition because less nutritious food options are typically inexpensive and more affordable than healthier items.

Throughout the COVID-19 pandemic, news headlines highlighted the effects of an inequitable system and its threat to the nation’s pandemic recovery. A Western University study reported the COVID-19 vaccine rollout in Toronto struggled to increase vaccination rates in hotspot areas because the immigrant populations in many of these neighborhoods struggled with access to digital booking, language proficiency, and lack of familiarity with the healthcare system. Additionally, the lack of vaccination centres in hotspot areas in comparison to other Toronto neighborhoods led to longer waiting times.

With the increased digitization of healthcare and health services, Canadians without digital access risk being left behind. This is especially true for Canadians living in rural and northern areas.

Making a positive impact

Equity was at the heart of several client mandates NATIONAL supported in 2021. Healthcare industry leaders such as Roche, Rethink Breast Cancer, and Wellspring Canada partnered with NATIONAL to raise awareness and implement action around addressing some of the most prevalent health equity issues in Canada.

Soaring with Roche

In October 2021, with NATIONAL’s support, Roche, the world’s largest biotech company, announced Soaring with Roche, a public platform for collaboration and innovation to tackle some of the most pressing healthcare challenges. One of the grounding principles of Soaring with Roche is its inclusivity - from healthcare professionals across all fields to industry leaders, academics, innovators, to the everyday Canadian, anyone is welcome to contribute their voice.

Roche asked nearly 100 Canadians across the country alongside international participants, to come together to identify five key challenge areas in healthcare, which would become the focus areas of Soaring with Roche. This diverse group of medical professionals, researchers, business leaders, and community advocates, identified Health Justice as one of the most pressing issues in Canadian healthcare alongside Health Literacy, Data Sharing, Waiting for Healthcare, and Aging Powerfully. Soaring with Roche will be a platform to foster diverse and inclusive conversation, ideas, and actions to create a system where every Canadian has an equal opportunity to be healthy regardless of who or where they are.

Rethink Breast Cancer

For Breast Cancer Awareness Month, NATIONAL worked with Rethink Breast Cancer, a Canadian cancer charity, to amplify Uncovered: A Breast Recognition Project. Uncovered is a digital and print resource that aims to help Black, Indigenous and People of Colour cope with breast cancer by shedding light on the physical and emotional scars breast cancer can leave, on the bodies of those they can identify with.

Uncovered was created by Rethink Breast Cancer in collaboration with Michelle Audoin, a Black woman with metastatic breast cancer (MBC) who struggled with the lack of post-surgery photos of women that she could identify with during her cancer experience. The resource calls on the Canadian healthcare system and healthcare professionals to end the disparities and discrepancies facing people of Colour when diagnosed with breast cancer.

Wellspring Canada

Wellspring is a Canadian not-for-profit organization offering a wide range of non-clinical services and programs, at no charge and without referral, to anyone, with any type of cancer, at any stage in their journey. During the pandemic, many people with cancer reported experiencing heightened isolation and increased anxiety. Wellspring quickly transitioned many of its services and programs online to ensure those with cancer continued to receive a wide range of high-quality, compassionate support as they dealt with an unprecedented public health situation in addition to living with a challenging disease.

Through its transition to online, Wellspring was able to reach an expanded demographic of cancer patients who could not attend in-person groups due to costs associated with traveling to physical locations, as well as those who were too ill to even leave their homes.

Where can we go from here?

To promote and achieve health equity, governments and health systems, companies, and patient organizations must work to lift current existing healthcare barriers whenever possible. Gaining and establishing health equity demands a combination of political, community, and personal effort.

We need to start by:

1. Listening and understanding how health disparities in a community will affect certain groups.
2. Respecting people of all groups and making an active effort to involve them in enacting change.
3. Evaluating how well policies aimed at health equity are currently working in Canada.
4. Understanding that positive change requires a commitment and dedication to a journey of lifelong learning.

A promising future of health equity in Canada is not possible without the inclusivity of voices and leadership from organizations, innovators, and activists from across the country. NATIONAL is looking forward to supporting our clients on this journey by helping facilitate important conversations, driving action, and reaching new audiences and stakeholders to help drive change.