Earlier this week, the Centre for Research on Inner City Health released a report linking patient incomes to types of admissions to hospitals in the Toronto Central LHIN. The report found that people with low and high incomes in Toronto are hospitalized for different reasons:
- More high income patients received same-day surgeries than low income patients;
- More low income patients were hospitalized for mental health issues;
- More high income patients than low income patients had day surgery;
- Alternative level of care (ALC) patients – patients waiting to be transferred to a lower-intensity care facility – were more likely to have low incomes;
- More low-income patients visited emergency departments than high-income patients for non-urgent reasons.
These findings raise alarms about the underlying reasons why low income people rely more heavily on parts of the health care system that are designed primarily to respond to crises. People with low income often lack access to primary care that helps to prevent health problems from becoming urgent. On top of this, they also tend to have poorer access to the basics of life that enhance good health, like safe and affordable housing, sufficient income to afford nutritious food, and stable and adequately paid jobs.
The CRICH study provides an excellent opportunity for Toronto hospitals to learn about the social and economic backgrounds of their patients and to make sure that their services meet all their patients’ needs. This research was commissioned by the Hospital Collaborative on Marginalized and Vulnerable Populations. In preparing hospital equity plans, all struggled with limited socio-economic data on their patients and utilization patterns. A further value of this study is as a call to action to invest in policies and programs that improve the health of the most vulnerable Ontarians.
The Wellesley Institute has a range of resources for policy makers on health equity planning and operationalization, and health promotion, including a health promotion equity lens and a mental well-being impact assessment. The Wellesley Institute also recently partnered in the Community Health Centres of Greater Toronto Health Equity Plan.