[EQ] Innovations in Delivering Services to Vulnerable Populations

Frontline Health Care in Canada: Innovations in Delivering Services to Vulnerable Populations

David Hay, Emily Hines, Judi Varga-Toth

Canadian Policy Research Networks - CPRN Research Report F|63. September 2006

 

Available online as PDF file [106p.] at: http://www.cprn.org/documents/45652_en.pdf

 

“…..outlines the barriers faced by frontline health workers in caring for Canada’s most vulnerable populations.

 

The purpose of the report was

1) to better understand the nature of populations in Canada who are unserved or underserved by the mainstream health care
    system, in particular people in rural and remote communities, people living in the inner city, and people living in conditions of poverty and low income;

2) to explore and describe the nature of frontline health services; and

3) to describe the public policy environment in which patients and providers on the margins have been operating.

The diversity of urban populations and significant gaps in research, data collection and comparative analysis of sub-populations makes it difficult to comprehensively describe the overall health status of urban marginalized groups. It is clear, however, that some subpopulations living in urban areas are facing challenging economic, social and environmental conditions with one result being poor health. Conditions that determine health such as education, employment, housing, and food are less than adequate for some Canadians living in urban areas. Health care can help, but vulnerable urban populations often face difficulty in accessing mainstream health care services.

 

The health status of the population living in Canada’s diverse and distinct non-urban regions, including rural, remote and northern regions, is lower than that of their urban counterparts. Aboriginal peoples (First Nations, Metis and Inuit), in particular, tend to have the poorest overall health status in Canada. Rural, remote and northern populations exhibit a set of health needs influenced by aging, depopulation, poverty and occupational hazards. Health needs for rural, remote and northern populations may be particular to the environment, geography, changing demographics, a common health need present in a rural environment, or the need for health concerns to be expressed in a “rurally sensitive” way.

 

Critically important to the health of vulnerable Canadians living in both urban and rural areas are issues related to social causes of ill health. The problem is not, or certainly not only, lack of health care provision, inappropriate health care delivery systems, and barriers to accessing care.

While access to health care is one “determinant” of health, it is only one of a long list of factors that research has clearly demonstrated significantly affects the health of populations. Furthermore, while there are similarities in determinants of health in urban and rural areas in Canada, there are also significant differences. This fact argues well for the appropriateness of community-based frontline health responses to health care needs – because they have the ability to respond to local determinants of health….”

 

Contents

Executive Summary

1. Introduction and Overview

2. Research Questions and Methods

3. Profiling the People on the Frontlines

3.1 Rural Populations in Canada

3.1.1 What Is Defined as Rural, Remote, Northern?

3.1.2 Health Status of Rural, Remote and Northern Canadians

3.1.3 Access to Health Care in Rural Canada

3.2 Inner City and Marginalized Populations in Canada

3.2.1 What Is Defined as Inner City?

3.2.2 Health Status of Inner City and Marginalized Canadians

3.2.3 Access to Health Care in the Inner City

3.3 Determinants of Health in Inner City and Rural Canada

4. Frontline Health Services in Canada

4.1 Rural, Remote, Northern and Aboriginal Communities

4.1.1 Access Points

4.1.2 Gaps in Access to Primary Health Care Services in Rural Canada

4.2 Inner City and Marginalized Communities

4.2.1 Access Points

4.2.2 Gaps in Access to Primary Health Care Services in the Inner City

5. Policy Perspectives for Frontline Health

5.1 Why Are Some People Healthy and Others Are Not?

5.2 Who Is Responsible for Community Health and Well-Being?

5.3 Supporting Community Innovation

5.4 Health Services, Access and “Waiting Times”

6. Conclusion

 

 

*     *      *     *

This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues.  [DD/ IKM Area]

"Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
Health Organization PAHO/WHO or its country members".
---------------------------------------------------------------------------------------------------
PAHO/WHO Website: http://www.paho.org/
EQUITY List - Archives - Join/remove: http://listserv.paho.org/Archives/equidad.html

 

    IMPORTANT: This transmission is for use by the intended recipient and it may contain privileged, proprietary or confidential information. If you are not the intended recipient or a person responsible for delivering this transmission to the intended recipient, you may not disclose, copy or distribute this transmission or take any action in reliance on it. If you received this transmission in error, please notify us immediately by email to infosec@paho.org, and please dispose of and delete this transmission. Thank you.