Lung cancer and equity report

What are social determinants of health?

The social determinants of health heavily influence lung cancer outcomes.

These determinants are “the conditions in which people are born, grow, work, live and age, and the wider set of forces and systems shaping the conditions of daily life.”

Examples of a person’s social determinants of health include:

• Whether resources are available to meet the person’s daily needs (e.g. safe housing, food markets)
• The person’s access to quality health care services
• Access to educational and job opportunities
• Historical trauma and ongoing racism and discrimination

The social determinants of health provide context to explain the interconnectedness of social, economic and environmental factors that affect health.

These determinants play a role in how people with lower income and people living in rural and remote areas are affected by lung cancer, and the journey they take when they have lung cancer.

Why do health inequities exist?

People in Canada are generally a healthy population. On average, we live relatively long lives, feel healthy and have access to high-quality care. But when you look beyond the averages, it is clear that some people do not benefit as much as others and do not have the same opportunity for good health.

This unequal distribution of power and resources has led to differences in health and wellness—also called “health inequities.” Health inequities are unfair and unjust systemic differences in health that can be avoided if appropriate interventions are made at the policy and system levels.

These inequities create the following barriers, which affect some populations more than others:

Systemic barriers

• Structural racism and discrimination experienced by First Nations, Inuit and Métis, and people of colour have resulted in mistrust toward the medical system and a lack of culturally appropriate services. This may cause people to delay seeking care or refuse recommended services.
• The COVID-19 pandemic has amplified challenges in the health system’s capacity to deliver care to underserved populations, who are more likely than the general Canadian population to develop COVID-19. This has magnified systemic barriers by increasing existing health inequities, such as unequal access to culturally safe care.

Economic barriers

• As income levels increase, so too does the health of individuals. In Canada, certain populations are more likely to have low incomes, including First Nations, Inuit and Métis, recent immigrants, people living with disabilities and single parents.
• People with lower income are affected by various factors that put them at greater risk of cancer. For example, people from lower socioeconomic groups report having difficulties making appointments with family doctors for urgent health needs, and are most likely to report that they haven’t seen a health care provider in 12 months. Individuals from those groups may have more difficulty accessing regular, consistent care from health care providers.

Geographic barriers

• With a shortage of rural physicians and specialists, rural residents have limited access to health care services and options for care, and must travel further to see a physician or receive specialized care. The financial, emotional and mental costs associated with travel create barriers for individuals who may not have the time or money to travel.
• First Nations, Inuit and Métis are especially affected by these barriers given that four in 10 live in rural or remote communities. For Inuit, seven in 10 live in Inuit Nunangat, where most communities are accessible only by air. Without regular access to health care, the overall health of individuals living in rural or remote areas is affected over time, and their care is delayed—all of which puts them at greater risk of cancer.