The Effects of Low-Income on Population Health

Vulnerable populations are defined as individuals, groups, and communities that are at a higher risk of poor health due to various factors. Vulnerable populations include the socioeconomically disadvantaged, racial/ethnic minorities, elderly, children, uninsured and those with chronic medical conditions. (AJMC, 2006).

I am going to be taking a closer look at the low-income population in Canada and the effects low-income has on health. The Government of Canada (2021) reported in 2014 that 8.8% of the Canadian population lived in poverty. Certain groups of Canadians were found to have higher

(Alpar, 2021)

incidences of low-income. These groups include the elderly, women, indigenous people, and immigrants (Government of Canada, 2021). Poverty creates barriers and affects one’s ability to obtain adequate housing, a nutritious balanced diet, access health care services and maintain good health. It is also associated with lower life expectancy, higher rates of suicide and increased risks of chronic disease & mental illnesses (Government of Canada, 2021).

Income inequality is becoming increasing prevalent in Canada as the income gap has steadily widened for the past 20 years. Health Quality Ontario (2016) reported that between 1995-2011 the family income for the highest 1/5th income group increased by 37% while the lowest 1/5th income group increased by 17%.

When examining primary risk factors for chronic diseases such as cardiovascular disease (CVD), income is often overlooked as the focus tends to be on modifiable lifestyle behaviours. However, studies have shown that a lower socioeconomic status (SES) results in increased CVD mortality and a higher prevalence of CVD risk factors such as smoking, obesity, hypertension, reduced physical activity and poor dietary habits (Kreatsoulas & Anand, 2010). There is a well-known association between heart disease and income – Statistics Canada showed over a 11-year period that 9.2% of low-income residents had heart disease versus only 2.9% in high-income residents (Lemstra et al., 2015). Heart disease has been found to be 2-3 times higher in people of low SES in Canada (Clark et al., 2011). This is because individuals with a lower SES tend to have comorbidities, engage in poor lifestyle choices, low physical activity levels, an unbalanced diet, poor compliance with medication regimens and limited access to health care services (Clark et al., 2011).

As a nation we need to address the income inequities that exist because of the widening income gap. There needs to be resources invested in strategies to reduce this gap and to improve the health & wealth of those in the vulnerable low-income populations. In Ontario, the Making Ontario Open for Business act was instilled to bridge the income gap by increasing the minimum wage to 15 dollars an hour by 2022 (Ontario, 2021). Other initiatives can also be developed to tackle the health-related challenges that come with a lower SES. These include providing affordable nutritious foods, equal access to health care services and programs tailored to the low SES population promoting heart healthy behaviours (e.g., increased physical activity, smoking cessation, and alcohol consumption reduction).

References

AJMC. (2006). Vulnerable Populations: Who are they?. The American Journal of Managed Care, 12(13), S348-352. Retrieved November 16, 2021, from https://www.ajmc.com/view/nov06-2390ps348-s352

Alpar, B. (2021). Monochrome image of a young man holding the empty wallet, focus on the hand, conceptual image of underpaid work [Image]. ShutterStock. https://www.shutterstock.com/image-photo/monochrome-image-young-man-holding-empty-1258069987

Clark, A. M., Duncan, A. S., Trevoy, J. E., Heath, S., & Chan, M. (2011). Healthy diet in Canadians of low socioeconomic status with coronary heart disease: Not just a matter of knowledge and choice. Heart & Lung, 40(2), 156-163. https://doi.org/10.1016/j.hrtlng.2010.01.007

Government of Canada. (2021, May 26). Towards a Poverty Reduction Strategy – A backgrounder on poverty in Canada. CANADA. https://www.canada.ca/en/employment-social-development/programs/poverty-reduction/backgrounder.html

Healthy Quality Ontario. (2016). Income and Health – Opportunities to achieve health equity in Ontario.HQONTARIO. http://www.hqontario.ca/portals/0/documents/system-performance/health-equity-report-en.pdf

Kreatsoulas, C., & Anand, S. S. (2010). The impact of social determinants on cardiovascular disease. Canadian Journal of Cardiology, 26(Suppl C), 8C-13C. https://doi.org/10.1016/s0828-282x(10)71075-8

Lemstra, M., Rogers, M., & Moraros, J. (2015). Income and heart disease: neglected risk factor. Canadian Family Physician, 61(8), 698-704. Retrieved November 16, 2021, from https://www.cfp.ca/content/61/8/698

Ontario. (2021, Nov 2). Ontario to Raise Minimum Wage to $15 an Hour. NEWS ONTARIO. https://news.ontario.ca/en/release/1001090/ontario-to-raise-minimum-wage-to-15-an-hour