INCOME
When considering income as a social determinant of health, it is important to outline how it affects the health of populations from both a material and psychosocial standpoint. Income shapes people’s material access to their needs, such as food, safe housing, healthcare services, education, and other resources and opportunities. Income also affects people’s self-worth, dignity and social relationships.
For a country that prides itself on equality of opportunity and social welfare, the distribution of access to these opportunities is largely skewed in favour of those with higher incomes. In particular, the political economy within Canada has led to widespread health inequities that could have been prevented if there wasn’t such an affinity for neoliberal capitalism and its associated public policy priorities of privatization, austerity, and deregulation. In terms of how this political economy has shaped income as a determinant of health, Canada is one of the world’s most unequal countries, with Canada’s 1% earning approximately 243 times the average citizen’s salary.
Of course, the government could have done more to narrow down income inequality through public policy initiatives such as greater income transfer programs, more publicly accessible services, and overall increased funding for various cash transfer and welfare programs. Reforms must be taken to properly address the health gaps in the social gradient. Thus, I advocate for universal income support as well as increased public investment in healthcare, education, and housing. Community-driven initiatives, like Calgary’s "Enough for All," emphasize inclusive solutions informed by Indigenous principles, which highlights community engagement as central to addressing income-related health inequities.
Today, the long-term effects of settler colonialism in Canada are evident in the health inequities that have arisen due to income inequality. Indigenous peoples in Canada continue to face adverse outcomes given the history of economic marginalization in addition to contemporary barriers to care. Poverty rates remain disproportionately higher in Indigenous communities, which has led to lower life expectancy and elevated rates of chronic diseases, including arthritis and diabetes. Inadequate housing and economic vulnerability have led to high rates of homelessness among Indigenous communities, with some of the highest rates seen in Alberta.
