Divergences of Determinants of Health between British Columbia and Newfoundland & Labrador
Written by Holly Heximer (from BC) and Travis Bolt (From NL)
British Columbia
In British Columbia (BC) the provincial government under the Ministry of Health and the individual health authorities, including Provincial Health Services Authority (PHSA), have identified three areas within social determinants of health that are priorities. Improving socio-economic, housing and education and literacy. Guiding documents include a Priority Health Indicators Report from PHSA. BC is also working on a Social Determinants of Health Standards to provide guidance; however, this has not been released yet.
In June 2020 the minimum wage in BC was increased to $15.60; however, in Vancouver, the living wage is $19.50 (CBC News, 2021). Minimum wage, nor income assistance or disability meet the cost of living in BC (BC Government, n.d.).
When looking at housing the focus has been on improving housing quality, affordability and the community and location. Per the 2018 Homeless Count, the three main barriers were low income, high rents and lack of suitable housing (Homelessness Services Association of BC, 2018). Reports also show that indigenous people struggle to find affordable housing off reserves (BC Government, n.d.). There have been a number of pilot projects and funding for housing regionally and provincially.
Education and literacy is another priority area including education equality amongst the population (BC Government, n.d). As with many of the other social determinants of health, this varies by region. From the Priority Health Indicator Report, the prevalence of kindergarten developmental vulnerability was 32-34% compared to the provincial average of 28% (Provincial Health Services Authority, 2016). To encourage further education the provincial government has eliminated interest for BC student loans (Student Aid BC, n.d.).
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Newfoundland and Labrador
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In Newfoundland and Labrador (NL) the provincial government along with the Department of Health provide policies and guidance to the four Regional Health Authorities. The NL government has identified multiple social determinants of health as priority points, these include improving income and social status, access to healthcare and education. Guiding documents include the Poverty Reduction Strategy, The Primary Health Care Framework 2015-2025 and The Way Forward: A guide to sustainability and growth in NL.
The Government of Newfoundland and Labrador’s Poverty Reduction Strategy takes a social determinant of health approach to help prevent, reduce and alleviate poverty. This work is important to primary health care because poverty and social conditions have been shown to be directly connected to health and well-being (Gov’n of NL, 2020). The minimum wage in NL is currently $12.15, this is compared to the suggested living wage of $18.85 to meet minimum day-to-day expenses and healthy eating (Sauliner, 2019). According to the Poverty Reduction Strategy, the NL government strives to meet a $15 dollar minimum wage by 2022.
Newfoundland and Labrador is geographically one of the largest provinces in Canada. In the entirety of the province, there is currently only one major hospital that provides many specialties and cancer care. The NL government with the guiding document, The Way Forward, is in the construction phase to build a brand new hospital that actually provides cancer care to the Western portion of the island, to be completed in 2023. A very startling statistic is that nearly 90,000 Newfoundlanders and Labradorians do not have a family physician (Newfoundland and Labrador Medical Association, 2021). Not having readily available access to a family physician negatively affects one health in many ways including early intervention and identification of health issues as well as management of acute and chronic health issues. Unfortunately, there is no document or plan I can find on access to physician care thus far in NL.
In Newfoundland, vital statistics found that 26% of males and 25.4% of females aged 25-64 years had an education level of less than high school (Statistics Canada, 2006). The government of NL has implemented many interventions to assist individuals with obtaining a higher level of education such as a long stand tuition freeze for post-secondary education. The NL government produced the education action plan to focus on areas such as indigenous education and decreasing teacher-to-student ratios (Government of NL, 2018).
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Comparing and Contrasting British Columbia to Newfoundland and Labrador
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There are many similarities between British Columbia and Newfoundland and Labrador for social determinants of health as well as some differences. Both provinces have large geographic areas including remote communities which limits access to healthcare. NL, primarily Labrador has a large indigenous population which is similar to BC. Both BC and NL have focused on education equality with NL freezing tuition on post-secondary education and with BC eliminating provincial student loan interest.
On the other hand, NL has high poverty rates with a high cost of living, in part because it is on an island. The minimum wage is much lower at $12.15 compared to BC’s minimum wage of $15.60. BC has a large housing crisis with high homeless numbers, making housing a top government priority.
References
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BC Government. (n.d.). Social Determinants of Health. Ministry of Health. Retrieved February 13, 2021, from https://www.health.gov.bc.ca/library/publications/year/2007/conversation_on_health/PartI/PartI_SocialDeterminants.pdf
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CBC News. (2021, June 1). B.C.’s minimum wage jumps by 75 cents on Monday, but living wage still out of reach. CBC News. https://www.cbc.ca/news/canada/british-columbia/minimum-wage-bc-june-2020-1.5590565
Government of Newfoundland and Labrador. (2003). Reducing Poverty in Newfoundland and Labrador: Working towards a solution. Retrieved from https://www.gov.nl.ca/publicat/povertydiscussion-final.pdf
Government of Newfoundland and Labrador. (2015). The Way Forward: A vision for sustainability and growth in NL. Retrieved February 14, 2021, from: https://www.gov.nl.ca/pdf/the_way_forward.pdf.
Government of NL. (2018). Education Action Plan. Retrieved February 15, 2021, from: https://www.gov.nl.ca/education/edu/EAP-report.pdf.
Homelessness Services Association of BC. (2018, December). 2018 Report on Homeless Counts in B.C. Retrieved from https://www.bchousing.org/research-centre/housing-data/homeless-counts
Provincial Health Services Authority. (2016, January). Priority health equity indicators for British Columbia: Selected indicators report. Population Public Health. Retrieved February 13, 2021, from http://www.bccdc.ca/pop-public-health/Documents/Priority%20health%20equity%20indicators%20for%20BC_selected%20indicators%20report_2016.pdf
Sauliner, C. (2019). A living wage for St. John’s, Newfoundland and Labrador. Canadian Centre for Policy Alternatives. Retrieved February 15, 2021, from https://www.policyalternatives.ca/sites/default/files/uploads/publications/Nova%20Scotia%20Office/2019/05/Living%20wage%20for%20St%20Johns.pdf
Student Aid BC. (n.d.). Eliminating Interest on B.C. Student Loans. Retrieved February 14, 2021, from https://studentaidbc.ca/news/general/eliminating-interest-bc-student-loan