What to know
- A recent study found Black Canadians are significantly more likely than white Canadians to delay or skip filling prescriptions because of cost.
- Suelyn Knight argues health inequities are driven by factors such as income, housing, education and systemic barriers to care.
- She says improving health equity requires targeted investments, not just universal healthcare programs.
- Knight argues addressing health inequities ultimately benefits the entire healthcare system and all Canadians.
All Canadians should have what they need in order to be healthy – that is what health equity looks like. However, a finding from a recent study highlighting that Black Canadians are about 75 per cent more likely than white Canadians to delay or forgo filling their prescriptions because of cost should set off alarm bells.
Editor’s note: The views expressed in this opinion article are those of the authors and do not necessarily reflect the views of Now Toronto.
It points to a stark truth too many people are still willing to ignore – many people in Canada, one of the wealthiest countries in the world, are being forced to choose between putting food on the table or buying the medications they need.
This is not an abstract policy failure, but a human one that lays bare the health inequities that exist in this country. They are real, measurable and worsening.
It is time to acknowledge the harmful effect of health inequities and invest in pragmatic solutions. The overlapping connections between race, income and health outcomes are striking and undeniable.
Communities that are underserved, marginalized and underrepresented – including Indigenous communities, Black and other racialized individuals and low-income populations – continue to face the greatest barriers in accessing healthcare.
At the same time, they also experience the greatest threats to their health based on social and economic factors – known as social determinates of health – including income, education, employment, housing, disability and food security.
These differences result in poorer health outcomes, higher rates of chronic disease and a shortened life expectancy – outcomes that are real, measurable, predictable and – most importantly – preventable.
A recent report by the Wellesley Institute examining the social determinants of health on diabetes risk in Black people highlights the need for targeted interventions that tackle not just the barriers they face in accessing healthcare, but also the broader sociocultural, environmental and economic factors that increase their risk of chronic diseases like diabetes.
Yet, at a time when the evidence of health inequities is clearer than ever, we are seeing a very troubling shift.
Equity is being dismissed by some as “woke” and divisive, as though it were an ideological matter that can be disregarded rather than an issue grounded in data, lived experience and public health necessity.
This is not just misguided, it is dangerous.
Health equity is not about giving some people more. It is about ensuring that everyone has what they need to achieve comparable outcomes for optimal health.
Accepting the truth of health inequity requires us to be honest about the fact that not everyone starts from the same place.
When someone cannot afford to fill a prescription, the consequences ripple outward. Chronic conditions worsen. Emergency room visits increase. Health systems become more strained. Costs rise for everyone.
Canada has long prided itself on having a strong and equitable health system, but the reality is it has many gaps and people from disadvantaged groups are more likely to fall through them.
This is why we need more investment in targeted strategies and in solutions that address not just symptoms, but also root causes.
Universal approaches alone will not close these gaps. If they did, we would not be here.
Equity requires us to intentionally examine the underlying reasons for inequities – including poverty, systemic racism, barriers in access and policy blind spots and the different ways they impact diverse communities – and then design solutions that meet people where they are.
It also requires empathy and understanding – something that cannot be legislated, but must be cultivated.
Empathy and understanding build trust and break down barriers by valuing individuals’ lived experiences and recognizing the harmful effects that systemic discrimination, stereotypes and biases can have on health outcomes.
We need to pair empathy and understanding with resources and targeted strategies that actually make a difference in the lives of people who are most affected.
This includes strategies such as addressing the social determinants of health and building a healthcare system tailored to the needs of those most affected by systemic barriers.
Equity is not a static achievement. It is an ongoing commitment. It’s not the time to retreat and dismiss equity as unnecessary or divisive. It is time to lean in, follow the evidence and invest in solutions that eliminate inequities.
Afterall, when we invest in health equity, everyone benefits.
Suelyn Knight is the Executive Director of Inclusion, Diversity, Equity and Accessibility at Diabetes Canada and a nationally recognized expert in leading IDEA initiatives across government, corporate and non-profit sectors.
