Health Inequities in Manitoba: Is the Socioeconomic Gap

Health Inequities in Manitoba: Is the Socioeconomic Gap in Health Widening or Narrowing Over Time?
• The disparity rate differences (i.e., the absolute difference of cumulative mental illness between
the lowest and highest neighbourhood income group) increased over time in both rural and urban
Manitoba. Furthermore, the absolute differences are consistently and substantially higher in urban
Manitoba, indicating a larger rate difference between lowest and highest neighbourhood income
groups in urban Manitoba.
What is this telling us?
• The socioeconomic gap in cumulative mental illness is widening over time for rural Manitobans and
is widening by absolute, but not relative, measures for urban Manitobans.
• By all measures, the socioeconomic gap is much larger in urban than in rural Manitoba.
• In both rural and urban Manitoba, there is a plateauing of cumulative mental illness in the last two
time periods.
• The minimal socioeconomic disparity in rural Manitoba contrasts to the disparity observed in urban
Manitoba. Disparity observed in urban areas may be due to migration of those with mental illness
to low neighbourhood income (core) urban areas. Alternately, the lack of disparity observed in
rural areas may reflect poorer access to mental health services by those with mental illness in low
neighbourhood income areas, thus a potential underdiagnosis or underreporting in rural Manitoba.
However, the heterogeneous nature of the rural neighbourhood income quintile areas compared
to the relative homogeneity of the urban neighbourhood income quintile groups may result in an
underestimate of the disparity in rural compared to urban.
Where to from here?
• Further exploration of the difference in disparity between urban and rural areas could involve
examining timing of mental illness diagnoses and residential mobility before and after diagnosis in
urban areas.
Manitoba Centre for Health Policy 141