"Examining the Consistency of Health Determinants Across Different Regions"

It is clear each province prioritizes the respective Determinants of Health differently. Simply assessing Canadian provinces like Ontario and New Brunswick there is grave differences in action and prioritizing. A classmate and I analyzed government data, reports, and surveys versus literature and research this time around. We also assessed how the governments allocated their budget.

Overview of Provincial Priorities and Action

When compared to other provinces like Ontario, the priority/top determinants in New Brunswick (N.B.) have a high focus on education (literacy rates in particular), income status, social status, and food security. There was also mention of the determinant of health status, with a focus on mental heath and Primary Health Care (PHC) access. 

Ontario had a high focus on income, income status, and education (childhood development). There was a great focus on infrastructure to ensure businesses and families were supported but we were surprise that the contributions of medicine and health care were quite limited (Public Health agency of Canada, 2013).

Both provinces focused/prioritized on income, education and health. Although the GNB hasn’t taken grave action, at least they were clearly identified.

When assessing the determinants of Health for N.B., the New Brunswick Health Council (NBHC, 2022) did focus on access to health services. The NBHC noted that N.B. continues to have a relatively poorer performance regarding perceived mental health and this seems to be getting worse.  Although we are not excellent, N.B. is presenting a little bit better in performance for the percentage of citizens who have a Primary Health Care (PHC) provider, compared to the Canadian average. There are pockets and gaps like in the Greater Fredericton Area (GFA) in N.B. where this suffers. While there has been significant population growth in recent years, access to PHC services has lagged behind. Fredericton has one of the lowest rates of access to PHC in the Country, with only 79% of residents having access (the provincial average is closer to 85%). The Government has recognized the issue with timely access to healthcare (New Brunswick Health Council, 2022). Chronic Obstructive Pulmonary Disease (COPD) has a great impact on hospitalizations across the province, as well as lung and cardiovascular disease, the leading cause of avoidable mortality in N.B.

The New Brunswick Medical Society (NBMS) noted there was a grave need in addressing the social determinants of health, such as housing and income. They noted is crucial in improving N.B’s healthcare system. The NBMS urges the government to advocate for policies and initiatives that target deep-rooted poverty, such as programs that promote education and literacy for at-risk youth and strategic investments in affordable housing and income support programs (New Brunswick Medical Society, 2023).

Within N.B. it is clear that the determinants of health are not evenly distributed in the population. The Government of New Brunswick (GNB, 2016) identified New Brunswickers with the lowest income and education levels experienced greater food insecurity and practiced poorer health behaviours than those with higher income and education levels. Government surveys and results also highlighted groups that experienced more chronic diseases and chronic disease risk factors than their more advantaged counterparts.  I would assume similar trends in Ontario. New Brunswick reports highlight that health literacy is essential to New Brunswickers’ capacity to manage their health properly. Although not great, the GNB must do better and take action.

There were some direct links around low income households being more likely to report being affected with chronic diseases such as cancer, heart disease, COPD, lung disease or diabetes. There was also correlation between those New Brunswickers without a high school diploma experiencing higher rates of cancer and diabetes than those with post-secondary graduation.

Ontario on the other hand had a high focus on the economy, income, and ensuring the working class, business and can thrive and succeed. The Government of Ontario clearly a focus to ensure more jobs/employment. They have recognized more jobs - comes with better income, since more income improves the social status of the individual. This certainly supports families in maintaining a good income and maintaining a good social status to ensure they stay healthy and encompass healthy lifestyles. Ontario created a Manufacturing Investment Tax Credit, to allow manufacturers to be more competitive and thus be able to invest in workers which aligns with employment and working conditions. There was a high focus on the physical environment such as building highways, transit, and infrastructure projects (like highway expansion, transit expansions, and hospital projects). There is also a plan to create 3000 new beds. There are grants to build and renew schools, and also a plan to create 86,000 childcare spaces. The Government of Ontario is certainly prioritizing physical environment, childhood experiences (healthy childhood development), access to health services, and education as a focus on the determinants of health.There is also an initiative for citizens to receive the Ontario Secondary School diploma and other certificates, highlighting again a focus on education (Government of Ontario, 2023).

The Ontario government is also committed to keeping gas and fuel costs low, making transit more affordable, creating supportive housing (including Indigenous supportive housing) and expanding the guaranteed annual income system for seniors. This is the only one that actually address income, but it also includes culture, via the Indigenous supportive house.

In terms of health care, the Governments of Ontario’s budget includes a greater focus to home care services, expanding pharmacist prescribing powers, and helping more Ontario students to become doctors. They are also including a program to help children leaving the welfare system to ensure a smoother pathway to education and training. This again has a focus on access to health services, childhood experiences and social supports and coping skills.

The Ontario government has also committed more funding to residential school burial site searches. This is the DOH of culture, support the Indigenous people of Ontario to find and commemorate the burial sites. They will also engage residential school survivors.

So, certainly some similarities and differences, however the Government of Ontario has certainly made key connections on where investments should be made to created success, they are also taking clear action. 

References

Government of Canada (2013, January 15). What Makes Canadians Healthy or Unhealthy? Government of Canada. Retrieved February 12, 2024, from https://www.canada.ca/en/public-health/services/health-promotion/population-health/what-determines-health/what-makes-canadians-healthy-unhealthy.html

Government of New Brunswick (2016). A Report from the Office of the Chief Medical Officer of Health. Health Inequities in New Brunswick. Retrieved February 3, 2024, from https://www2.gnb.ca/content/dam/gnb/Departments/h-s/pdf/en/Publications/HealthInequitiesNewBrunswick2016.pdf

Government of Ontario (2023, March 23). Government of Ontario. 2023 Ontario Budget: Building a Strong Ontario. Retrieved February 12, 2024, from https://budget.ontario.ca/2023/index.html

New Brunswick Health Council (2022, March 15). Observations from our Population Health Snapshot 2021. New Brunswick Health Council News and Articles. Retrieved February 4, 2024, from https://nbhc.ca/news/observations-our-population-health-snapshot-2021

New Brunswick Medical Society (2023, March 18). Addressing the Challenges in New Brunswick’s Healthcare System. Retrieved February 4, 2024, from https://www.nbms.nb.ca/addressing-the-challenges-in-new-brunswicks-healthcare-system/

Primary Care Survey (2022). Key Indicators. New Brunswick Health Council. Community Profile (Area 3) www.nbhc.ca

Public Health Ontario (2024, April 8). Public Health Ontario. Social Determinants of Health Snapshot. Retrieved February 12, 2024, from https://www.publichealthontario.ca/en/data-and-analysis/health-equity/sdoh