Intervention in Canada to improve health inequities

Intervention in Canada to improve health inequities
Intervention in Canada to improve health inequities

Intervention in Canada to improve health inequities

Order Instructions:

Although Canada is contiguous to the United States and has some cultural and historical similarities, Canada’s population enjoys a vastly superior health status. Reasons are many, can be traced historically, and are related to a different view of the role of government. The experience of Canada demonstrates that neither a heterogeneous population, nor a health system that has waiting lines for services, are reasons for poor health. By looking critically at what produces good health in Canada, much can be learned about steps the U.S. might need to take if population health is its goal.

The Canadian Best Practices Portal challenges Canadian public health practitioners and researchers to create upstream interventions aimed at the source of a population health problem or benefit. What is being done to address the influences on population health in Canada?
Search the Internet and scholarly research for examples of Canadian “upstream interventions” that can be put forth as examples of either effective or ineffective efforts to improve population health. This is a 4-5 pages):

The Assignment (4-5 pages):

1. Provide a description of an existing intervention in Canada, intended to improve health inequities. Include an explanation of the inequity and how the intervention targets upstream determinants of health.

2. Describe the organizations involved and/or social policies enacted in the implementation of the intervention.

3.Explain whether or not the intervention was/is successful and what lessons public health practitioners can learn from that experience that might improve population health in the United States.


Dinca-Panaitescu, S., Dinca-Panaitescu, M., Bryant, T., Daiski, I., Pilkington, B., & Raphael, D. (2011). Diabetes prevalence and income: Results of the Canadian Community Health Survey. Health Policy, 99(2), 116–123.
Retrieved from the Walden Library databases.

Feeny, D., Kaplan, M. S., Huguet, N., & McFarland, B. H. (2010). Comparing population health in the United States and Canada. Population Health Metrics, 8, 8–18.
Retrieved from the Walden Library databases.

Kirkpatrick, S. I., & McIntyre, L. (2009). The Chief Public Health Officer’s report on health inequalities: What are the implications for public health practitioners and researchers? Canadian Journal of Public Health, 100(2), 93–95.
Retrieved from the Walden Library databases.

Vafaei, A., Rosenberg, M. W. & Pickett, W. (2010). Relationships between income inequality and health: A study on rural and urban regions of Canada. Rural and Remote Health, 10(2), 1430.
Retrieved from the Walden Library databases.

Health Council of Canada. (2010). Stepping it up: Moving the focus from health care in Canada to a healthier Canada. Toronto, Canada: Health Council of Canada. Retrieved from

Public Health Agency of Canada. (2013, July 12). Key element 4: Increase upstream investments. Retrieved from
Public Health Agency of Canada. (2014). Retrieved from

Please apply the Application Assignment Rubric when writing the Paper.

I. Paper should demonstrate an excellent understanding of all of the concepts and key points presented in the texts.
II. Paper provides significant detail including multiple relevant examples, evidence from the readings and other sources, and discerning ideas.
III. Paper should be well organized, uses scholarly tone, follows APA style, uses original writing and proper paraphrasing, contains very few or no writing and/or
spelling errors, and is fully consistent with doctoral level writing style.
IV. Paper should be mostly consistent with doctoral level writing style.


Health inequities are avoidable imbalances that contribute to poor health. Solutions for such inequities may be found in upstream interventions that address social, economic and environmental situations. Social determinants include preventative strategies such as physical activity and proper diet as important ways of preventing chronic diseases and improving overall health (Gore & Kothari, 2012). In Canada, Ontario implements interventions aiming to influence environmental and social factors to address inequities in health.

There is increasing prevalence of chronic disease among certain pockets of the Canadian population. Problems associated with the high cost of treating such diseases necessitate efforts to implement interventions targeting their underlying causes. Canada renewed its commitment to public health in 2003 in a response strategy targeted towards addressing Severe Acute Respiratory Syndrome through healthy living interventions. The associated cost of treating chronic diseases threatens the sustainability of the healthcare system. This realization informs the implementation of a healthy living intervention in Canada through development of chronic diseases prevention guidelines (Gore & Kothari, 2012).

In Canada, low economic social status is measured in terms of literacy and income levels. It determines citizens’ vulnerability to cardiovascular disease, diabetes, asthma and chronic obstructive pulmonary disease (Dinca-Panaitescu, Dinca-Panaitescu, Bryant, Daiski, Pilkington, & Raphael, 2011). Studies show higher prevalence of chronic disease and lower life expectancy in low -income areas as compared to wealthier areas. Research also shows that job insecurity, unemployment, part-time employment and temporary employment negatively affects health as it is associated with elevated levels of chronic diseases such as blood pressure and increased risk of death from cardiovascular diseases. Aborigines, immigrants and people of color also have low incomes and are at higher risks of stress that triggers development of chronic diseases (Gore & Kothari, 2012).

Canada implements health policies aimed at preventing chronic illnesses by addressing upstream causes encompassing lifestyle, socioeconomic and environmental factors. One example of the policies is the 2009 Canadian Cardiovascular Society Guidelines advocating for reduced salt and simple sugars intake. It promotes the replacement of saturated and trans-fats with unsaturated, as well as higher consumption of vegetables and fruits. The guideline also recommends greater attention to weight control to prevent obesity and ensure that more citizens maintain a healthy body weight (Raine, 2010).

Health boards received instructions on the appropriate way to evaluate the population needs and tailor interventions to the groups facing the highest risk. Another policy is the Ontario guidelines for healthy eating and active living that informs various interventions to address health inequities in Ontario (Gore & Kothari, 2012). Aboriginal people and new comers in Canada have a higher prevalence of chronic illness often because of poor nutritional decisions and lack of opportunities for physical exercise. To address inequities among aboriginal people, there is an initiative to provide recreation and fitness equipment and youthful fitness ambassadors in their various locations. Other interventions in the Ontario guidelines for healthy eating and active living include provision for a web and phone based dietitian serving populations in remote areas. It also includes providing fruits and vegetables to schools through partnership with the ministry concerned with agriculture. Efforts to encourage physical activity include collaboration with urban planning designers to ensure that cities promote healthy living and that schools have routes that encourage physical exercise through walking and biking. The local public health units also oversee the compulsory programs and 36 heart health community partnerships to reduce cardiovascular disease (Ministry of Health Promotion, 2006).

The Ontario plan on active and healthy living is also referred to as ACTIVE2010 supports communities to implement community sports and physical activity and nutrition projects (Ministry of Health Promotion, 2006). The plan adopted a multi-sectoral approach targeting the population on a variety of levels. It includes actors from NGOs, private industry, service providers, and communities. Partnership between actors in healthcare is imperative in addressing the wide-ranging impact of social determinants in populations residing in diverse settings (Gore & Kothari, 2012).

The government in Ontario supports the intervention through policies that guide enhanced physical activity in schools, providing access to nutritious foods to children and encouraging hygiene and safety in the environment. Community organizations actively participate through facilitating health promotion trainings to prevent the occurrence of chronic illnesses among at risk individuals. Private companies also participate by creating health and wellness programs for their staff including healthier food choices and exercise. Some companies in the food industry are also keen in providing healthier food selection and creating awareness on the same (Ministry of Health Promotion, 2006).

The physical exercise interventions are tenable and have resulted in substantial benefits to the population. The interventions assist Ontarians to become more physically active through community sports and physical activity projects that are largely supported through the communities in action fund. The implementation of the Ontario’s trail strategy also encourages physical activity through provision of outdoor walking spaces in various areas for all (Ministry of Health Promotion, 2006). In as much as interventions targeting to reduce salt content in packaged and restaurant foods are tenable, the dietary recommendations for preventing chronic diseases remain largely unmet in Canada. Only a few companies have positively responded to the guidelines’ recommendations. The industry progress is underwhelming because many other companies are yet to take voluntary measures to reduce salt in their food products. It shows that regulatory controls are necessary to increase the number of companies acting to reduce sodium levels in processed foods (Raine, 2010).

The Canadian Heart and Health strategy and Action Plan recommends that creating heart friendly environments through education, legislation, and policies aimed at promoting healthy eating and physical activity are efficient interventions in addressing upstream determinants of health. An examination of environment-based interventions to prevent cardiovascular diseases in Ontario and indicates that they failed to address the social causes or determinants of illnesses. Interventions in settings at schools, workplaces, government buildings and communities are insufficient in addressing unfavorable living conditions and factors that create inequity. There is need for greater political will to invest more aggressively in prevention to achieve success (Raine, 2010).

Complete success of the Ontario’s healthy eating and active living plan is dependent upon greater political will to support aggressive implementation including legislative measures. Public health practitioners in the United States must ensure that when adopting such interventions, there is a solid legal foundation to ensure success. The US requires implementing strategies that address health inequities emanating from low-income and racial factors are addressed through population specific measures. A multidisciplinary approach is also imperative in ensuring that communities, government agencies and private sector players coordinate their efforts. There must be enforceable laws on wellness programs, food industry parameters and urban planning. These factors coupled with concerted efforts between public health agencies, education, food and agriculture, companies and the communities provide prime conditions for success.


Dinca-Panaitescu, S., Dinca-Panaitescu, M., Bryant, T., Daiski, I., Pilkington, B., & Raphael, D. (2011). Diabetes prevalence and income: Results of the Canadian Community Health Survey. Health Policy, 99(2), 116-123.

Gore, D., & Kothari, A. (2012). Social Determinants of Health in Canada: Are Health Initiatives There Yet? A Policy Analysis. Internatinal Journal for Equity in Health, 11(41), 1-14.

Ministry of Health Promotion. (2006). Ontario’s Action Plan for Healthy Eating and Active Living. Retrieved September 24, 2014, from

Raine, K. D. (2010). Addressing Poor Nutrition to Promote Heart Health: Moving Upstream. Canadian Journal of Cardiology, 21-24.

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