By Derek Abma
OTTAWA — Money may not be everything, but a new report from Statistics Canada suggests it can be a matter of life and death — with poorer Canadians more likely to die younger.
The federal agency tracked mortality rates of 2.7 million Canadians aged 25 or older between 1991 and 2006. Out of this group, 426,979, or 16 per cent, had died by the end of the study period.
Those who were in top 20 per cent for family income were most likely to still be alive after 15 1/2 years, and that probability shrank as one moved further down the income ladder.
For men, those in the second-highest fifth of people for income were 12 per cent more likely to die during the study period than those in the richest category. There was a 21 per cent bigger chance of death for those in the third highest income group, 35 per cent for the fourth, and 67 per cent for the poorest group.
It was a similar pattern for women. Those in the second-highest income group were seven per cent more likely to die than those in the top income group, 14 per cent more in the third group, 25 per cent more in the fourth, and 52 per cent more for the lowest income group.
“It is accurate to say that lower-income people are more likely to die at a younger age,” said Michael Tjepkema, a researcher at Statistics Canada’s health analysis division and one of the report’s co-authors.
“I think the study speaks to the fact that these income inequalities, in terms of health, are quite consistent across a wide range of causes of death,” he added.
For both men and women, the biggest differences were seen between the lowest and second-lowest income groups.
Tjepkema said this latest document backs up findings of another report he helped write, released almost two years ago and using the same data, that showed the probability of living to the age of 75 was 73 per cent for men in the highest income group versus 50 per cent in the lowest. For women, it was 83 per cent for the highest income group and 70 per cent for the lowest.
This latest report said that if all income groups had mortality rates equal to those in the top category, there would have been 19 per cent fewer deaths among men and 17 per cent fewer among women, or the equivalent 40,000 fewer deaths annually if these proportions were applied to the whole country.
It was found that the steepest differences in mortality rates among income groups were found when deaths were linked to risk-based behaviours such as smoking, alcohol consumption and drug use.
For example, men in the lowest income group were more than five times as likely to die from an alcohol problem than those in the top income group. Women at the bottom of the income scale were more than four times as likely to die from an alcohol disorder than those at the top.
“This is consistent with research indicating that, compared with people in higher socio-economic categories, those in lower socio-economic categories are more likely to engage in health-risk behaviours,” the report said.
There also appeared to be a connection between income and attaining effective medical care when looking at men who died before they reached the age of 75. The report noted a stronger link between lower incomes and dying of a cause in which medical intervention could have prevented or delayed death, such as hypertension or influenza, than diseases like lung and colon cancer where medical care is not considered likely to save someone’s life.
With women, it was found that income was more closely linked with mortality when involving causes not considered medically treatable. It was noted that breast cancer, seen as a treatable ailment, was not found to have a mortality rate linked to income.
Tjepkema said it’s not within his agency’s mandate to prescribe solutions, but he did say that “the reduction of socio-economic inequalities in health is an explicit objective of health policies in Canada,” adding that the Public Health Agency of Canada funded this study.
Stephane Shank, a spokesman for the Public Health Agency and Health Canada, said the government “has taken concrete steps and initiatives to address challenges for vulnerable populations in accessing safe and nutritious food.”
He noted programs to improve the food available in remote northern communities, awareness programs for prenatal nutrition and efforts to improve nutritional information on food packages.
Armine Yalnizyan, an economist with the Canadian Centre for Policy Alternatives, said it’s been known for decades that there is a link between affluence and life expectancy. She said it’s due to a variety of factors including the quality of housing people live in, nutrition and the health of a person’s mother when they are born.
Among the solutions, Yalnizyan suggests “doing something on the income side to moderate income inequality; actually giving poor people a little more money,” and helping to create more affordable and safe housing.
The Council of Canadians, a group that regularly speaks out on national issues related to health and the environment, said the Statistics Canada report shows the need for provincial premiers to demand a bigger commitment to health care from the federal government when they meet at the Council of the Federation meeting next week.
“Health care and the social determinants of health desperately need appropriate funding,” Adrienne Silnicki, the council’s health care campaigner, said in statement to Postmedia News. “Today, the provinces pay 80 per cent of the health-care bills; that’s really unacceptable.”
