Social inequalities in health (SIH)

Social inequalities in health (SIH) are differences in health between different population groups based on their social position. These differences depend particularly on income, level of education, ethnocultural background, and gender. For example, life expectancy at birth is significantly lower among people living in disadvantaged areas than among those living in more affluent areas.

Understanding SIH

SIH are attributable to the unequal distribution of resources within a collectivity. These resources are also known as the social determinants of health. These determinants influence living conditions—such as food security and housing quality—as well as access to goods and services and the quality of different living environments, such as the safety of playgrounds in nearby parks, pollution around the home, and housing quality.

In general, gaps widen as social status decreases, meaning that SIH affect the entire population to varying degrees. In addition, various forms of marginalization or discrimination—such as sexism, racism, and homophobia—interact with each other. As a result, certain individuals and groups experience the cumulative effects of multiple inequities.

Unfair and preventable

SIH are preventable because they result from an unequal distribution of resources that can be addressed or whose effects can be mitigated. They are also unfair because everyone should have the same opportunities to achieve their full potential for health and social fulfillment, regardless of their social status. For example, First Nations and Inuit peoples are particularly affected by these disparities due to the historical and ongoing consequences of colonialism and racism.

Monitoring SIH

The INSPQ has been mandated by the Ministry of Health and Social Services to develop a system for monitoring social inequalities. It has developed the strategy and indicators that make up the Québec Social Health Inequalities Surveillance System (SSISSQ), in collaboration with its regional and national partners. With this system, the public health network benefits from a common methodology and harmonization of practices. to measure and monitor SIH. The findings provided by this system are crucial for informing, raising awareness, and mobilizing decision makers about the impact of SIH on improving the health status of Québec's population.

To develop public health policies and programs aimed at reducing SIH, consult our indicators.

Measuring disadvantage

Disadvantage is often used as a criterion for social differentiation and is used, among other things, to examine social inequalities in health. It refers to a disadvantage in relation to the local community or society as a whole, to which the individual belongs. Disadvantage can be detected in individuals' living conditions, in their immediate living environment, and in their broader environment, at the neighbourhood, city, regional, and national levels. Living conditions and living environments constantly interact with each other.

The Material and Social Disadvantage Index (MSDI) measures the disadvantage of Québec and Canadian populations on a small geographical scale. It is used to document and highlight inequalities in health and access to care related to disparities in material and social resources. This tool supports decision making and the allocation of public resources in regions and local communities. To view the mapping of the deprivation index, See the Géoportail de santé publique du Québec.