3.4 Disparities in Health
VIDEO: Public Health Agency of Canada — Social Determinants of Health
The following video provides a brief explanation of the relationship between disparities in health experienced by different populations in Canada and the SDoH.
A SDoH framework focuses our attention on health inequalities and the causes of those disparities. The aim is to better understand how marginalization (social and economic) impacts health and well-being (Allan & Smylie, 2015). Not all populations have the same access to social and economic resources. With regard to substance use issues, populations that are negatively impacted by resource allocation are at a greater risk for experiencing substance use problems and adverse outcomes. Indigenous people in Canada are one such population (Kim, 2019).
Research shows that Indigenous people, particularly youth, “carry a disproportionate burden of harms from problematic substance use in relation to the general population of Canada” (McKenzie et al., 2016, p. 378). For example, Indigenous youth who use drugs are thirteen times more likely to die prematurely in comparison to similar aged non-Indigenous youth (Jongbloed et al., 2017). These health outcomes and mortality rates are tied in part to Indigenous specific SDoH, such as experiences of historical trauma, racism, and discrimination (Government of Canada, 2018; Jongbloed et al., 2017). Researchers have concluded that health outcome differences between Indigenous and non-Indigenous peoples in Canada are a result of the “complex intersections of historical and present-day injustices, substance use and barriers to care” (Jongbloed et al., 2017, p. E1352).
The Government of Canada has acknowledged the egregious harms it has caused to Indigenous people and communities. In terms of substance use related harms, one of the main themes in the 2018 report “Public Consolation on Strengthening Canada’s Approach to Substance Use Issues” is supporting Indigenous people (Government of Canada, 2018). Despite such acknowledgements, Indigenous communities continue to suffer from health inequities as evidenced by the rate of opioid-related poisonings (overdoses) during the COVID-19 pandemic. For example, in Ontario there has been a 132% increase in poisonings among Indigenous people, versus a 68% increase among non-Indigenous people (Chiefs of Ontario and Ontario Drug Policy Research Network, 2021).
Poisoning is a more medically accurate and less stigmatizing option to the term overdose. A poisoning is an injury to the body that occurs when excessive amounts of a substance are ingested (accidentally or on purpose) or when the substance ingested is contaminated/adulterated with other substances, sometimes referred to as toxic drug poisoning (e.g., Fentanyl adulterated heroin) (Canadian Drug Policy Coalition, October 7, 2020; The Chief Staff, March 11, 2021)
