Socioeconomic status (SES) is the social and economic position of an individual in a given society. Indicators of socioeconomic status such as occupation, education, and income are what influence health outcomes. Higher SES is associated with a lower risk of mortality and morbidity whereas an inverse relationship is seen with low SES (Adler & Newman, 2002; American Psychological Association, 2015). Health problems experienced in low SES groups include low birthweight, cardiovascular disease, hypertension, arthritis, diabetes and cancer. In Canada, only 43% of people with the lowest incomes reported having very good or excellent health compared with 73% of people with the highest incomes (Public Health Agency of Canada, 2013). The former group also had a greater risk of early death and more illnesses. Given these observations, the relationship between SES and health can be strongly attributed to income; however, could the aforementioned relationship be due to other social and psychological factors independent of wealth?
In 1978, researchers Wilkins and Adams demonstrated that the richest Canadians received 12 additional years of good health relative to poor Canadians. Nearly four decades have passed and the problem persists. The link between social status and health is referred to as “social health inequality” (Association of Faculties of Medicine of Canada, 2014). This is an unfair and avoidable situation where socioeconomic conditions determine an individual’s risk of getting sick, and access measures to prevent or cure the disease (WHO, 2008).
Poverty in Canada
Compared to other affluent countries, Canada has low rates of public spending and high child poverty rates, and has received several UN reprimands for failing to improve child and family poverty1,2. Though estimates vary, poverty affects approximately three million Canadians, 20% (or 600,000) of whom are children3. It is believed that around 15% of children, almost one in six, live below poverty thresholds4,5. Meanwhile, child poverty rates in Ontario lie around 14%, suggesting that almost 19,000 children are born into low-income families every year6,7. Perhaps most disappointingly, this is not a new, or unrecognized problem. In 1989, recognizing the high child poverty rates in Canada, the Canadian House of Commons voted unanimously to eliminate child poverty by 20008; this was followed shortly after by Canada’s ratification of the UN Convention on the Rights of the Child in 1991. However, almost 25 years after this original motion was passed, some argue that the situation has deteriorated rather than improved9.