1. SUMMARY: In order to achieve optimal health, individuals and populations require a fair distribution of both the benefits and burdens of society. Without this, certain individuals and groups will be disproportionally disadvantaged, particularly when it comes to health.
2. BARRIERS TO EQUITABLE HEALTHCARE
2.1. SOCIAL DETERMINANTS OF HEALTH
2.1.1. Income and Income Distribution: Income is the most important SDH, impacting other SDH, determining resource access and predicting accessibility of healthcare services.
2.1.2. Education: Individuals and groups with lower levels of educational attainment are less likely to access healthcare services and more likely to experience barriers with access.
2.1.2.1. Those with low levels of education also experience lower levels of health literacy, which impairs their ability to access healthcare services.
2.1.3. Unemployment: Stress and negative coping may arise from unemployment. Also those that are unemployed will not have access to supplementary insurance plans through work.
2.1.4. Housing: Those without stable housing may have difficulty accessing healthcare services, especially those without a fixed address.
2.1.5. Social Exclusion: Those experiencing social exclusion are not able to actively participate in society, marginalizing them and making accessing healthcare services difficult.
2.1.6. Lack of a Social Safety Net: When society lacks necessary social assistance and support programs, those with little access to resources are further marginalized.
2.1.7. Lack of Access to High Quality Health Services
2.1.8. Aboriginal Status: Historical negative impacts of colonization persist today and impede Aboriginal Peoples' ability to access healthcare services and achieve optimal health status.
2.1.9. Gender: Women are more likely to be negatively affected by the SDH, consequently negatively impacting their health.
2.1.10. Race: Racial minorities experience societal and institutional racism that impacts their ability to access healthcare services.
2.2. SYSTEM ISSUES
2.2.1. Cure Focused Healthcare System
2.2.2. Inadequate Healthcare Workforce
2.2.3. Ineffective and Inefficient System Funding Structure
2.2.4. Poor integration of Health Information Technologies
2.3. SUMMARY: various SDH and system issues impair individual and population access to vital healthcare services. In order to ensure fair and just access to healthcare services, these factors need to be considered and rectified.
3. DEFINING HEALTH EQUITY
3.1. Equitable Health Care Access means that all individuals have access to affordable, high quality, culturally and linguistically appropriate care in a timely manner. This includes regular preventive care, in addition to emergency care, as well as mental health support.
3.2. Health Equity: All people can reach their full health potential and should not be disadvantaged from attaining it because of their race, ethnicity, religion, gender, age, social class, socioeconomic status or other socially determined circumstance.
3.3. Involves the fair distribution of resources needed for health, fair access to the opportunities available, and fairness in the support offered to people when ill.
3.4. Fairness, Justice and Values are the focus.
3.5. Important to the Idea of Health Equity is Social Justice!
3.6. Health INEQUITY: Health inequities are health differences between population groups–defined in social, economic, demographic or geographic terms– that are unfair and avoidable.
4. FACILITATORS OF EQUITABLE HEALTHCARE
4.1. Fair Distribution of Resources
4.1.1. All citizens having access to necessary health-related resources in their community
4.1.1.1. Achieved by: - Having an adequate healthcare workforce - Having an educated and advocacy focused healthcare workforce - Coordinated interprofessional care teams - Collaboration between key stakeholders to ensure health system that is fair, just and equitable. This should include patients, providers and key community members - Providing services that meet the needs of the greatest number of people - Focusing on meeting the needs of society's most vulnerable and marginalized populations - Appropriately implemented healthcare technologies - Integration of data and information from hospitals, clinics, community care centres and other healthcare settings - Efficient and cost-effective allocation of limited funding - Comprehensive and universal health plan that covers essential services for all individuals, regardless of age, gender, race or class - Strong social support for a just and fair healthcare system - Health-related policies that are inclusive, fair and just
4.2. Implementation of Health Information Technologies
4.2.1. E-SHIFT
4.2.2. Remote Patient Monitoring
4.2.3. PHRs and other health records
4.2.4. Adequate data collection algorithms
4.2.5. Smartphone enabled healthcare apps
4.2.6. Video Consultation Services
4.2.7. CCAC E-Homecare
4.2.8. TeleHealth
4.3. Comprehensive Understanding of the Social Determinants of Health
4.3.1. All of the SDH can positively impact one's ability to reach their full health potential
4.3.2. A system that understands and takes into account the impact SDH have on the individual and the population creates a more equitable health system by working towards balancing out these factors