Canada’s Chief Public Health Officer calls on health leaders to tackle stigma to build a more inclusive health system in Canada.
Overall, Canada is a healthy nation. However, not everyone has the same opportunity to achieve optimal health. Too often, this is due to how people are treated. Stigma in our health system leads to persistent barriers to effective care and services for those most in need.
Today, Canada’s Chief Public Health Officer, Dr. Theresa Tam, released her 2019 Annual Report on the State of Public Health in Canada: Addressing Stigma: Towards a more inclusive health system. The report presents health trends in Canada and takes an in-depth look at the impact of stigma on our health. Through her report, Dr. Tam calls on leaders in Canada’s health system to understand and address stigma.
“Stigma is persistent in our health system. It creates barriers to equitable service and effective care for those who are most in need,” Dr. Theresa Tam Chief Public Health Officer of Canada said. “We need to address, reduce and ultimately eliminate the stigma so that we can provide a safe, effective and compassionate health system that puts people first. Together, we can create the most inclusive health system in the world.”
Stigma is a fundamental cause of health inequity. The report highlights that stigma associated with health issues such as mental illness, HIV status, obesity or substance use cannot be addressed without also tackling threats to equity such as racism, homophobia, transphobia, ageism and sexism. Stigma blocks access to health services, negatively affects both mental and physical health, and exposes people to violence and trauma. It also keeps people away from the resources they need to live a healthy life, such as having housing, an income and accessible health services.
Some key trends identified in this year’s report include:
- Improvements in some social factors that affect health. For example, fewer adults and children are living in poverty, and more people in Canada are pursuing post-secondary education.
- Substance use and its related harms continue to affect many people in Canada. Last year, more than 12 people in Canada died every day from an opioid-related overdose.
- Vaping among youth is increasing rapidly across the country, and we do not yet fully understand the related harms.
- Sexually transmitted and blood-borne infections, such as syphilis, are on the rise.
- Rates of antibiotic-resistant infections are increasing, making common infections harder to treat.
- The rapid rise in measles cases in many countries this year and gaps in vaccination rates is concerning.
People in Canada interact with the health system in many ways—at medical appointments, at pharmacies, and during medical emergencies. System-wide interventions including education, training, practice and policy are needed to drive cultural change to end stigma. Implementing cultural safety, trauma-and violence-informed approaches, stopping stigmatizing language and meaningfully engaging those with lived and living experience will help lead to an inclusive health system.
“Dr. Tam’s report is extremely important in addressing the systemic barriers that prevent some Canadians from accessing health care services in Canada,” The Honourable Patty Hajdu Minister of Health said. “The findings shine a light on the long-lasting impact that stigma has on Canadians’ health, and illustrate how we must increase and accelerate our collective efforts to end discrimination in health care. Our government will stay focused on ending stigma and discrimination in all forms to ensure that our public health care system remains a point of pride long into the future.”
One in four Canadians has reported experiencing at least one form of discrimination, with racism being the most common type reported.
- Indigenous people and Black Canadians are twice as likely as the general population to report being treated unfairly.
- LGBTQ2S community members are three times more likely to report being treated unfairly than the general population.
- 20 per cent of Canadians with a mental illness report being affected by negative opinions or unfair treatment because of their poor mental health.
- 50 per cent of Canadians in recovery from substance use disorders report experiencing stigma and discrimination.
Every health system employee and volunteer has a role, working together to avoid the divisive separation of “us” and “them”. This report calls on health leaders, researchers and individuals to look at the complex pathways through which stigma and discriminatory practices impact people’s health and wellbeing and offers a new roadmap to end stigma in our health system.
“The widespread presence of stigma and discrimination within and outside of the health system results in Canada being a country where not every person has the ability to reach their full health potential,”Ian Culbert Executive Director, Canadian Public Health Association said. “Those of us in the health and social services sector – in fact all Canadians – need to reflect on our own personal attitudes and beliefs and our employers need to review the systems that reinforce stigma and discrimination so that we can reduce health inequities in our society.”
Each year, the Chief Public Health Officer of Canada is required to submit an annual report on the State of Public Health in Canada to the Minister of Health.