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What is health equity?

WHAT IS HEALTH EQUITY? 

I grew up in north-west Calgary, close enough to my elementary school to walk and bike there every day. Despite this, my community was a typical suburban Calgary development – no sidewalks, no reasonable transit access, and the closest grocery store was an hour walk away.  Not exactly walkable. 

After I graduated, I moved to Victoria, BC and lived there for eight years. Here, I saw that communities could offer choices, that I didn’t have to rely on my car. Not only did I live a few blocks from the ocean, but also an easy five-minute walk from a grocery store, clinic, bookstore, coffee shops, community centers, and pretty much everything else I needed. I walked or biked to do all my errands (I got very good at biking with a heap of groceries), and my car, only taken out for weekend hikes, quite literally began to grow moss on it.  

Biking through Victoria

One summer, I moved back to Calgary. Being a student and on a limited budget, I couldn’t afford to live in one of Calgary’s walkable neighbourhoods (Sunnyside, Bridgeland, Lower Mount Royal…), so I moved back in with my family in the suburbs. One day, I decided to walk home from work. “I walk all the time in Victoria, why can’t I do it here?”  

20 feet into my walk home, the sidewalk ran out. I checked the bus schedule, but the next bus wasn’t scheduled to arrive for another 45 minutes. I found myself teetering on the edge of a busy road with cars whizzing by at 70 km/hr. Eventually, I cut through a park, and met a dead end at a chain link fence. Admitting defeat, I climbed over the fence, stood on the side of the road, and waited for a ride. 

So – what does this have to do with health, and health equity? 

Health equity means that everyone has the same access to opportunities that allow them to live a full, long, and healthy life. However, achieving optimum health is disrupted when preventable conditions get in the way. Development and government policies meant that the community I lived and worked in was made for cars, not for people. My student loans meant that I had to live in an affordable neighbourhood that didn’t have sufficient active transportation options. So, despite my wishes to lead a lifestyle where I walked, biked or bussed to get around, forces outside of my control meant that this simply wasn’t an option for me – I didn’t have a choice. But health equity is much more than being able to move from A to B any way you want. 

For many of us, when we picture health, we picture visits to our doctor, eating well, and being physically active. But the things that really shape our health are the environment around us, where we work, play, live, and the systems with which we interact. These factors, called the social determinants of health, make some groups of Canadians healthier than others.  

  1. Aboriginal status 
  2. Disability
  3. Early life
  4. Education
  5. Employment and working conditions
  6. Food insecurity
  7. Health services
  8. Gender
  9. Housing
  10. Income and income distribution
  11. Race
  12. Social exclusion
  13. Social safety net
  14. Unemployment and job security 

Let’s think about the current state of Calgary’s economy. How might this impact the average Calgary family, a couple with one or two children?   

A parent loses a job during the economic downturn (unemployment and job security). This has meant moving to a more affordable house, but it is affordable for obvious reasons – the house is in need of repair, has mold growth, and is close to an industrial area (housing). Because they now live on one income, they have had to cancel their gym passes, swim lessons for their children, and change to a more affordable, unregulated day care (income, early life).  Health benefits were lost, so asthma medication for one of their children (aggravated by living close to an industrial park and busy roads) must be paid for out of pocket (health services, social safety net). The family is now buying cheaper, highly processed foods instead of fresh, nutritious foods, to save money to pay for housing (food insecurity). Even if they had been going to their doctor for regular check ups and biking to get exercise, living close to an industrial area that has a lack of access to nutritional foods, and the presence of household mold would all negatively impact their health. 

We can see how health really isn’t just about “an apple a day keeps the doctor away”. Our health is shaped by many factors. Governments and decision makers, practitioners and citizens must work together to ensure all Canadians have access to opportunities that support them to live a long, full, and healthy life. 

By Katie Lore

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References

Statistics Canada. (2017). Calgary [Economic region], Alberta and Alberta [Province] (table). Census Profile. 2016 Census. Statistics Canada Catalogue no. 98-316-X2016001. Ottawa. Released November 29, 2017. Retrieved from http://www12.statcan.gc.ca/census-recensement/2016/dp-pd/prof/details/page.cfm?Lang=E&Geo1=ER&Code1=4830&Geo2=PR&Code2=48&Data=Count&SearchText=calgary&SearchType=Begins&SearchPR=01&B1=All&TABID=1 

Juha Mikkonen & Dennis Raphael. (2010).  Social Determinants of Health, The Canadian Facts. Retrieved from http://thecanadianfacts.org/the_canadian_facts.pdf 

Hannah Moffat & Sume Ndumbe-Eyoh. (2013). National Collaborating Center for Determinants of Health: Let’s Talk Health Equity. Retrieved from  http://nccdh.ca/images/uploads/Lets_Talk_Health_Equity_English.pdf 

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