The Chief Public Health Officer's report on health inequalities: what are the implications for public health practitioners and researchers?

Abstract

The first annual report of the Chief Public Health Officer on the State of Public Health in Canada draws notable attention to health inequalities in Canada. This report provides a compelling presentation of our current health status and the uneven distribution of health across the population, noting persistent and sizeable gaps in life expectancy, infant mortality, self-reported health, prevalence of chronic diseases, and other health indicators between higher- and lower-income groups, as well as the extraordinary disadvantage experienced by Canada's Aboriginal peoples. However, the report falls short of offering a critical approach to addressing and reducing health inequalities. It fails to stimulate thinking about integrated strategies by profiling current responses that do little to address the underlying structural drivers of health inequalities and ignoring the population health framework's recognition of the complex interactions among the determinants of health. Despite its shortcomings, the report shines a light on major health inequalities in Canada, providing a foundation for further action. Public health workers in this country must build on this foundation, working together and with all sectors and levels of government to identify and implement integrated strategies to reduce health inequalities and inequities in Canada.