Determinants of self-perceived health for Canadians aged 40 and older and policy implications.

BACKGROUND: Perceived health status indicates people's overall perception of their health, including both physical and psychological dimensions. The aim of this study was to examine the determinants of self-perceived health for Canadians aged 40 and older using data from the Canadian Community Health Survey (2010). METHODS: Multiple logistic regression models were employed to identify factors associated with self-perceived health in two age groups: Adults aged 65+ and Adults aged 40-64. RESULTS: We found that higher income was significantly associated with better health status while chronic conditions and stress were associated with worse health status. In the 40-64 and 65+ age groups, individuals in the highest income bracket were 4.65 and 1.94 times, respectively, more likely to report better health than individuals in the lowest income bracket. The difference in the level of income associated health inequities between the two age groups point to the need for understanding the reasons behind lower inequities among seniors and how much the social protections provided by the Canadian government to seniors contribute to lowering inequities. CONCLUSIONS: Though Canada has a national public health insurance system providing coverage to all Canadians, health inequities associated with income persist providing further evidence of the importance of the social determinants of health. Examining the extent of these inequities and what factors influence them helps direct policy attention. In addition to documenting inequities, this paper discusses policy options for reducing the identified inequities.

The public health implications of the use and misuse of tobacco among the Aboriginals in Canada.

Tobacco smoking among the Aboriginal populations is a major public health issue in Canada. It remains a major contributory risk factor to the poor health status as well as years of potential life lost seen among the indigenous people. The use of tobacco has a spiritual importance to the people as a means of making connection to the Creator, but unfortunately tobacco smoking has taken a recreational aspect which has little or no connection with Aboriginal spirituality. The non-traditional use of tobacco is believed by the Elders to be disrespectful to the Aboriginal culture and traditional way of life. There is an increase in rate of use of smokeless tobacco as well as smoking of tobacco among the youth with increase in percentage among females. There are socioeconomic implications as well as adverse health effects of the misuse of tobacco on the Aboriginal people that need to be addressed. The healthcare professionals have a unique role in helping patients to reduce tobacco use within the community through programs that are culturally sensitive and relevant. Successful strategies requires general support from the community and it is very important that some of that support comes from community leaders, including spiritual, professional, administrative and elected policy makers.