Health Inequities in Manitoba: Is the Socioeconomic Gap

Health Inequities in Manitoba: Is the Socioeconomic Gap in Health Widening or Narrowing Over Time?
Chapter 1: Introduction and Methods
Introduction and Description of the Research Team
Health status and the use of health and social services are key indicators for studying patterns in population
health. However, it is not only the actual rate or prevalence 1 that is important, but the distribution of health
or health services within the population itself. Are there inequities in health status or the use of services by
socioeconomic groups within Manitoba? Many previous MCHP reports have looked at neighbourhood income
and geographical disparities, both cross–sectional and over time. But no report has focused on health inequity
so specifically, nor has analysed how to measure these inequities in the most methodologically rigorous way.
This report, called Health Inequities in Manitoba: Is the socioeconomic gap in health widening or narrowing over
time?, is designed to focus on inequality, both the methodology used to quantify inequality and the analysis of
existing inequality within Manitoba’s socioeconomic groups.
In 2009, the 62 nd World Health Assembly (Resolution A62/52) called upon the international community to “take
note of the final report of the Commission on Social Determinants of Health (2008) and its recommendations”;
“to consider health equity in working towards achievement of the core global development goals, and to
develop indicators to monitor progress”; “to develop and implement goals and strategies to improve public
health with a focus on health inequities”; and “to ensure dialogue and cooperation among relevant sectors with
the aim of integrating a consideration of health equity into relevant public policies and enhancing intersectoral
action.” This current health inequities project, to study the influence of neighbourhood income on health
inequality, is one initiative by Manitoba Health to both collect evidence and to develop a methodology for
ongoing monitoring and evaluation of socioeconomic inequality in health outcomes.
Through an ongoing grant relationship between the Manitoba Centre for Health Policy (MCHP) and Manitoba
Health, MCHP scientists produce research reports that are of direct interest to the policy–making and planning
needs of the provincial government. As part of the provincial impetus to reduce health inequality, Manitoba
Health and MCHP jointly decided on a research project to document socioeconomic inequality in selected health
and social outcomes, in a “rapid turnaround” deliverable project. This report will help undergird the need for
population–based data for various provincial reports looking at the health status of Manitobans and on how to
reduce inequity. Thus, this particular project, by necessity, had to be very targeted as to the number of indicators
explored, the range of indicators in order to ensure a wide scope of health inequities, and the realistic approach
that indicators must be based on previous validated work using the Repository of databases housed at MCHP. On
advisement of the Deputy Minister of Health, an Advisory Group was struck that represented key health planning
sectors—Manitoba Health’s Health Information Management Branch, the Chief Public Health Office, key medical
officers of health from both southern and northern RHAs, and Healthy Child Manitoba. Normally, an Advisory
Group to a deliverable meets once or twice a year throughout the duration of the two–year project. However,
given the mandate of“rapid turnaround”, the Advisory Group in this situation became part of the research team,
meeting frequently throughout January to April 2010, helping choose the small group of indicators for the
report, helping refine the analyses, and helping write the results. So this group became part of the research team
itself, and as such are named as research scientists for this project.
MCHP is a unit of the Department of Community Health Sciences in the University of Manitoba’s Faculty
of Medicine. According to its mission, MCHP is a research centre of excellence that conducts world class
population–based research on health services, population and public health, and the social determinants of
health. MCHP develops and maintains the comprehensive population–based data repository on behalf of
1 Throughout this report, terms in bold typeface are defined in the Glossary at the end of this report.
Manitoba Centre for Health Policy 1