Patients who lived in Ontario’s most-disadvantaged neighborhoods had a 60 percent increase in the risk of death within 30 days following elective surgery. By comparison, students from more affluent communities have a markedly reduced chance. This alarming finding stems from a comprehensive cohort study involving over one million patients, highlighting persistent health disparities across the province. Published in the medical journal Jama, the study underscores the urgent need to address social determinants of health that contribute to these inequalities.
Recent research found that almost two percent of patients die in the month after surgery. Yet, this statistic has been stagnant over the last ten years. Most significantly, people from low-income communities have 52 percent increased risk of death compared to rich people. This disparity emphasizes the correlation between socioeconomic status and health outcomes, offering a stark reminder of the challenges faced by vulnerable populations.
Insights from Researchers
Sandy Torres, a sociologist at the Quebec Observatory on Inequality, helped us develop these insights further, particularly when it comes to understanding what these findings mean. “Unfortunately, it doesn’t surprise me at all,” she stated, expressing concern over the ingrained healthcare inequalities prevalent in Ontario. Social determinants of health play a big role in affecting access to needed surgical care, especially in our marginalized communities,” Torres added.
Additionally, Torres explained that these material and social disadvantages can contribute to delays in accessing healthcare services. For one, you might only go to the doctor when it’s already a dire issue. And it can actually cause people to stop pursuing care altogether,” she said. This lag in response can worsen health conditions, even leading to increased death rates of marginalized populations.
This study points to a larger trend observed in several other Canadian and Western studies. It brings into focus that the inequalities in healthcare listed go further than Ontario. Torres emphasized that these are likely similar problems in Quebec. He appealed for systemic changes to address these inequities nationwide.
Addressing the Root Causes
These research findings shed light on the need for a broader, more multifaceted intersectional and cross-sector approach to address healthcare inequalities. Torres favors wide-ranging solutions that include direct financial relief with measures to address root causes that make where they live dangerous. “This requires better financial support, but it can involve improvements to the neighborhood. It’s about allowing people to be self-sufficient so they can buy enough good-quality food, have decent housing, and be able to clothe themselves,” she noted.
Torres continued to emphasize the impact of meeting life’s essentials first as a place to start to rectify disparities and poor health outcomes. “Participating in social life to a minimum extent and having some leisure activities are part of basic needs, and of course, being able to take care of oneself and have access to healthcare like everyone else,” she emphasized. Through an intentional focus on these foundational elements, the people living in these marginalized and disadvantaged neighborhoods will see increased health, equity, and quality of life.
The study serves as a critical reminder that addressing healthcare inequalities requires a concerted effort from multiple sectors within society. Torres underscored the necessity for data-driven initiatives, stating, “It’s a major contribution of the study to put a number on it, to quantify this association. We need this kind of data.”
The Broader Implications
These findings in this study aren’t just numbers—they’re real life impacts on real lives caused by the systemic racism embedded in our healthcare system. These social inequalities are a direct driver of health harms. Instead, we must commit to making healthcare more accessible to those who can least afford it.
