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HEALTH  I N E Q U A L I T I E S
The biggest health problem in Canada is inequality. The overall improvement
in our health status masks the grim reality that health inequalities among
social classes are growing — as they are in most highly developed
countries. In Canada:
• Healthy life expectancy is three to four years less in low-income
neighbourhoods than in high-income neighbourhoods.
• The infant mortality rate in low-income neighbourhoods is almost double
that in high-income neighbourhoods.
• The average birth weight for babies born in low-income neighbourhoods is
one-quarter pound less than for those born in high-income neighbourhoods.
• People living on low incomes report higher rates of smoking and lower
levels of physical activity than people with higher incomes.
Inequality takes many forms: income is a crucial factor, but there are
others. In our society, lower income often leads people to feel
undervalued. This marginalization is a complex phenomenon, and its
consequences vary among individuals. But on the whole, the fewer resources
you have, the more likely you are to be in poor health, which in turn
reduces your prospects for financial success. Inequality begets inequality,
and the effects span generations. Poverty rates are predictors of things to
come. Poverty has
a detrimental impact on the health of children, and unhealthy children
will, in time, affect the health of the nation. The health care system is
relatively powerless to overcome these health effects.

Recent work in Canada has focused on the differences between lower and
higher income groups and the threshold at which health is affected. Some
intriguing research has shown that the health of the entire population is
better in cities where wealth is more evenly distributed. Canadian cities
have become more segregated along income lines in recent years, and this
raises concerns for social policy and population health. For example, in
Toronto, the average income of the richest 10 per cent of families rose by
23 per cent between 1980 and 2000, while the average income for the poorest
families fell by four per cent (Chart 5).

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