The Determinants of Health and the Affects on British Columbians

Our health is affected by many things. Some of these factors we are aware of, while others require a more critical analysis to be discovered. The determinants of health allow us to see how health is impacted from many views (Government of Canada, 2020). The Government of British Columbia has created a list of factors that affect health through a social context.

The Government of Canada has identified several components that influence both individuals and communities. These factors include the following: income status and societal position; securement of employment and conditions in which one works in; education and comprehension; experiences throughout childhood; environments in which people live; abilities to cope and available social supports; health-promoting behaviors and practices; accessibility to health services; biological and genetics predispositions; genders; cultures; and race (Government of Canada, 2020). By analyzing the determinants and the affects they have on populations, health disparities can be identified, and in some cases, modified. (World Health Organization)

The Government of British Columbia has begun to establish a set of social determinants of health (SDoH) to help identify and understand inequities that are present in British Columbia (Government of British Columbia, 2021). Social determinants of health are more specific in context of determinants of health (Government of Canada, 2020). The government of British Columbia identifies the following: "cultural identity and immigration status, indigenous identity, socio-economic status, housing security, food insecurity, occupation and employment including higher risk work history, language, and social capital/adhesion" (Government of British Columbia, 2021, para. 3). Based on the SDoH, each provinces has its own factors affecting health, some factors which may be in common, and some factors which may be unique.

When discussing British Columbians and the SDoH, there a several topics which become obvious. Indigenous people, homelessness, the overdose pandemic and how they are affected by the SDoH will be discussed.

First off, according to a study in 2011, there are over 232,000 Indigenous people living in British Columbia (Government of British Columbia, n.d.). This is important to acknowledge as health disparities for Indigenous people "include lower life expectancies, higher rates of chronic health conditions, higher rates of incarceration, and increased likelihood of experiencing poverty" (Bethune et al, 2019, p 173). Bethune et al, discuss how an income gap, lack of post-secondary education, reduced employment rates, food security, and high risk behaviors amongst indigenous people directly affect the health of this population (2019).

While being sensitive to cultural practices and beliefs, and while working with community leaders (Bethune et al, 2019), health disparities, as experienced by the Indigenous people of British Columbia, can be identified and improved upon. Several agreements have been created and signed by the Government of British Columbia and the First Nations Health Authority to aid in eliminating disparities that exist for Indigenous people (Government of British Columbia, 2021). Furthermore, the Office of Indigenous Health works with indigenous people and organizations to create culturally sensitive policies to promote health (Government of British Columbia, 2021).

Those living in British Columbia can attest to the fact that homelessness is an ongoing issue in the province. A report from 2018 surveyed twenty-four communities in British Columbia and discovered 7,655 people who identified as homeless (The Homelessness Services Association of BC et al, 2018). One can assume that due to the transient realities of those experiencing homelessness, it can be difficult to obtain accurate statistics. We can, however, acknowledge the health disparities that these individuals experience. A lack of housing, education, job security, and social standing, are all SDoH affecting the health status of those experiencing homelessness (Clifford, Wilson, & Harris, 2019).

The Province of British Columbia has several programs in place to safeguard and improve the health of this vulnerable population and include the following: the Homeless Community Action Grant, BC rent Bank, The Homeless Outreach and Aboriginal Homeless Outreach Program, The Homeless Prevention Program, The Emergency Shelter Program, The Extreme Weather Response Program, The Province Wide Homeless Count, Modular Housing, Supportive Housing, and Woman's Transition Housing and Supports (Government of British Columbia, 2021). Regardless of these initiatives, homelessness continues to be evident across British Columbia.

Lastly, the province of British Columbia has been experiencing an alarming rate of drug overdoses. In 2020, there were 1,726 illicit drug toxicity deaths, compared to 986 in 2019, and 1,549 in 2018 (British Columbia Coroners Service, 2021). In the first quarter of 2021, there have been 680 illicit drug death as noted by the B.C. Coroners Service (2021). Some SDoH noted to identify at risk groups include the following: the male gender; people 30-49 years of age; and those residing in Vancouver, Surrey, or Victoria (British Columbia Coroners Service, 2021). Those who inject drugs are impacted by the SDoH as they tend to be unemployed or homeless, lack food security, and identify as experienced recent violence (Kerman et al, 2020).

The Government of British Columbia has been active to combat the increase in opioid related deaths through an increase of $322 million in funding from 2017-2020 (Government of British Columbia, n.d.). This increase in funding has benefited the Community Crisis Innovation Fund, Community Action Initiative, the Community Overdose Crisis Intervention Grant, and the Overdose Emergency Response Centre (Government of British Columbia, n.d.). An increase in funding to various groups and organizations helps to create change at a community level which in turn benefits both individuals and communities alike.

As discussed in the blog, it is obvious that social factors can greatly impact members of society. Specific to British Columbia, the health inequities of Indigenous people, those experiencing homelessness and those impacted by the opioid crisis have been affected by specific SDoH. There have been many initiatives created by the Government of British Columbia, but more work is yet to be done. As continued efforts persists, may we one day see the health quality of these communities improve.

References

Bethune, R., Absher, N., Obiagwu, M., Qarmout, T., Steeves, M., Yaghoubi, M., Tikoo, R., Szafron, M., Dell, C., & Farag, M. (2019). Social determinants of self-reported health for Canada's indigenous peoples: a public health approach. Public Health, 176, 172-180. https://doi.org/10.1016/j.puhe.2018.03.007

British Columbia Coroners Service. (2021, June 1). Illicit drug toxicity deaths in BC: January 1, 2021-April 30, 2021. https://www2.gov.bc.ca/assets/gov/birth-adoption-death-marriage-and-divorce/deaths/coroners-service/statistical/illicit-drug.pdf

Clifford, B., Wilson, A., & Harris, P. (2019). Homelessness, health and the policy process: A literature review. Health Policy, 123(11), 1125-1132. https://doi.org/10.1016/j.healthpol.2019.08.011

Government of Canada. (2020, October 7). Social determinants of health and health inequalities. https://www.canada.ca/en/public-health/services/health-promotion/population-health/what-determines-health.html

Government of British Columbia. (n.d.). How the province is responding. https://www2.gov.bc.ca/gov/content/overdose/how-the-province-is-responding

Government of British Columbia. (n.d.). Indigenous people. http://www2.gov.bc.ca/gov/content/governments/indigenous-people

Government of British Columbia (n.d.). Office of indigenous health. https://www2.gov.bc.ca/gov/content/health/about-bc-s-health-care-system/aboriginal-health

Government of British Columbia. (2021, January). B.C. social determinants of health standards. https://www2.gov.bc.ca/gov/content/health/practitioner-professional-resources/health-information-standards/standards-catalogue/bc-social-determinants-of-health-standards

Government of British Columbia. (2021, January). Homelessness. https://www2.gov.bc.ca/gov/content/housing-tenancy/affordable-and-social-housing/homelessness?keyword=homelessness

Government of British Columbia. (2021, January). Indigenous health. https://www2.gov.bc.ca/gov/content/governments/indigenous-people/supporting-communities/health

Kerman, N., Nanoni-Millar, S., Cormier, L., Cahill, T., & Sylvestre, J. (2020). "Its no just injecting drugs": Supervised consumption sites and the social determinants of health. Drug and Alcohol Dependence, 213. https://doi.org/10.1016/j.drugalcdep.2020.108078

The Homelessness Services Association of BC, Urban Matters, and BC Non-Profit Housing Association. (2018). 2018 Report on homelessness counts in B.C. prepared for BC Housing. https://hsa-bc.ca/_Library/Report_on_Homeless_Counts/Final-2018-Report-on_Homeless-Counts-in_BCV4.pdf#:~:text=A%20total%20of%207%2C655%20individuals%20were%20identified%20as,majority%20were%20sheltered%20%2863%25%29%20and%2037%25%20were%20unsheltered

World Health Organization. (n.d.). Social determinants of health. https://who.int/health-topics/social-determinants-of-health#tab=tab_1