Canada’s is having an impact on Canadians’ mental and physical health, according to public health researchers at the ֱ.
In , the team found statistical associations between income inequality and a higher risk of “hospitalizations of despair” — especially drug overdose — and all-cause hospitalizations. Hospitalizations and deaths of despair are defined as being due to drug overdose, suicide attempt or alcohol-related liver disease.
Income inequality isn’t only about the prevalence of poverty in a community — it also involves the size of the income gap between the richest and poorest residents, the researchers explain. Income inequality has increased in Canada over the past 20 years, .
“The greater the gap, the greater the likelihood of experiencing a hospitalization due to despair,” says principal investigator , associate professor in the School of Public Health and .
“We tracked almost 200,000 people over a 13-year followup in Canada who had these preventable hospitalizations,” explains , who carried out the research for her PhD and is now a postdoctoral fellow with . “This represents a large burden on the health-care system, and on people and their communities.”
The research team followed 27.6 million working-aged Canadians in 286 census districts in a population-based longitudinal cohort, linking data from the , the and the .
During that time, more than 100,000 people experienced a drug overdose-related hospitalization, 70,000 went to hospital for alcohol-related liver disease and 22,000 were admitted to hospital due to a suicide attempt.
With each district’s increase in inequality, the researchers found a 38 per cent increase in overall hospitalizations of despair and a 51 per cent increase in overdoses. The results confirm the team’s , which showed an association between income inequality and an increased risk of deaths of despair, drug overdose and all-cause death.
Even controlling for factors such as mean income, ethnicity, education, or urban versus rural, the results apply to people at all levels of income, the researchers say.
“In communities with high income inequality, it’s really hard to feel a sense of connection with your neighbours,” says Benny. “You might feel like it’s hard to relate or maybe you don’t trust those around you, and it works both ways, whether you’re a high income earner or a lower income earner. It’s a level of uncertainty and disconnect within the space where you spend the majority of your time.”
The team hopes their work will inform policy discussions about ways to reduce income inequality and prevent deaths of despair.
“We need more resources in areas with high income inequality, more mental health programming, changes to services for people who use drugs. We want to intervene before it’s too late.”
Pabayo’s research group will continue to build on previous studies on the associations between inequality and health outcomes, including , , and . He also intends to explore the potential impact of various wealth redistribution options such as the .
This research was funded by the through the . Co-author is at the .