Health Policy
Article in Press, Corrected Proof - Note to users
 doi:10.1016/j.healthpol.2005.12.010
Copyright © 2005 Elsevier Ireland Ltd All rights reserved.

Review

Health disparities in Canada today: Some evidence and a theoretical
framework

Katherine L. Frohlicha, , , Nancy Rossb and Chantelle Richmondb

aUniversité de Montréal, Group de Recherche Interdisciplinaire en Santé
(GRIS), C.P. 6128, Succursale Centre-Ville, Montréal, Que., Canada H3C 3J7
bDepartment of Geography, McGill University, Montréal, Que., Canada

Available online 7 March 2006.

Abstract
This paper documents contemporary evidence on patterns of health
disparities in Canada and suggests theoretical mechanisms that give rise to
these patterns. The overall health of Canadians, as measured by life
expectancy or mortality, has improved dramatically over the past 30 years
and some disparities have diminished slightly (e.g., life expectancy by
income group for men), while others have increased (e.g., diabetes for
Aboriginal peoples). Arguably the most egregious health disparities in
Canada are those existing between Aboriginals and the rest of the Canadian
population. This paper focuses specifically on three social determinants
and their effects on disparities in health; Aboriginal status, income, and
place. Overall we take the approach that disparities in health could be
alleviated by reducing inequities in the distribution of these
determinants. We further argue that these social determinants are proxies
for opportunities, resources and constraints; all of which influence health
outcomes. We suggest that policies focus on reducing the social inequities
that lead to health disparities in Canada, rather than focusing on the
disparities in health alone. Since the social determinants described here
have been found to influence an array of disease outcomes, tackling them,
rather than their outcomes, may have a greater overall influence on the
health of the population.

Keywords: Health disparities; Canada; SES; Determinants of health;
Theoretical framework

Corresponding author. Tel.: +1 514 343 6430; fax: +1 514 343 5645.
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