Determinants of health have stronger impact on Canadians' health than healthy lifestyle

Dec 16 2010

Latest Health Council of Canada report says healthy lifestyle not enough; tackling determinants of health have a stronger impact on Canadians' health

A report released today by the Health Council of Canada declares that unless governments change their approach to addressing the needs of poorer and socially disadvantaged Canadians, we are destined to continue to spend large amount of dollars on our health care system. Governments must expand their approach to health promotion in order to tackle the major societal factors that lead to poor health and to take pressure off health care budgets.

The report Stepping It Up: Moving the Focus from Health Care in Canada to a Healthier Canada indicates that health disparities play a significant role in health system costs. It states that ongoing spending on acute care and programs encouraging a healthy lifestyle is not enough to improve the overall health of Canadians, particularly those who live in or close to poverty.

"Good health is not simply a matter of diet and exercise," says John G. Abbott, CEO of the Health Council of Canada. "These things matter, but research shows that other factors such as our income, employment, home and work environment, and social relationships have a stronger impact, on our health and well-being."

The report highlights income as a particularly strong determinant of health. In fact, Canadians with the lowest incomes are more likely to suffer from chronic conditions like diabetes, arthritis and heart disease, live with a disability, be hospitalized for a variety of health problems, have many mental health issues and to die earlier. Furthermore, these same Canadians are twice as likely to use health care services as those with the highest incomes. In 2010 the estimated health care expenditure in Canada is $192 billion. An estimated 20% of that cost may be attributable to income disparities.

Making an impact on the underlying determinants of health will require governments to think and work differently. The report underscores the need for a "seismic shift" in how politicians and governments think about health, calling for a better balance between investing in an acute care system and investing in the factors that materially affect our health.

"Canadians' health and a healthy population must be viewed as the responsibility of governments and society as a whole, not just that of the ministries of health or health promotion," says Abbott. "Governments need to govern more collaboratively, in an approach that links multiple ministries, multiple levels of government, and other sectors of our society."

The report credits Canadian governments for beginning to move in this direction, with attention to poverty-reduction strategies. However, there is still a need for governments to shift the allocation of funds to programs and services that target the poor, underemployed, and disadvantaged Canadians.

"In the end," says Abbott, "governments need to recognize that unless we challenge the status quo about how to improve the health of Canadians, we are going to continue to pour billions of new dollars into the formal health care system and achieve very little."