Health Policy 79 (2006) 132–143 Review Health disparities in Canada today: Some evidence and a theoretical framework Katherine L. Frohlich a,* , Nancy Ross b , Chantelle Richmond b a Universit´ e de Montr´ eal, Group de Recherche Interdisciplinaire en Sant´ e (GRIS), C.P. 6128, Succursale Centre-Ville, Montr´ eal, Que., Canada H3C 3J7 b Department of Geography, McGill University, Montr´ eal, Que., Canada Abstract This paper documents contemporary evidence on patterns of health disparities in Canada and suggests theoretical mechanisms that give rise to these patterns. The overall health of Canadians, as measured by life expectancy or mortality, has improved dramatically over the past 30 years and some disparities have diminished slightly (e.g., life expectancy by income group for men), while others have increased (e.g., diabetes for Aboriginal peoples). Arguably the most egregious health disparities in Canada are those existing between Aboriginals and the rest of the Canadian population. This paper focuses specifically on three social determinants and their effects on disparities in health; Aboriginal status, income, and place. Overall we take the approach that disparities in health could be alleviated by reducing inequities in the distribution of these determinants. We further argue that these social determinants are proxies for opportunities, resources and constraints; all of which influence health outcomes. We suggest that policies focus on reducing the social inequities that lead to health disparities in Canada, rather than focusing on the disparities in health alone. Since the social determinants described here have been found to influence an array of disease outcomes, tackling them, rather than their outcomes, may have a greater overall influence on the health of the population. © 2005 Elsevier Ireland Ltd. All rights reserved. Keywords: Health disparities; Canada; SES; Determinants of health; Theoretical framework Contents 1. Introduction ............................................................................................. 133 2. The main health disparities in Canada today ................................................................ 133 3. The theoretical framework ................................................................................ 134 4. The determinants of health disparities in Canada ............................................................ 135 4.1. Aboriginal status ................................................................................... 135 4.2. Income ........................................................................................... 137 4.3. Place ............................................................................................. 138 * Corresponding author. Tel.: +1 514 343 6430; fax: +1 514 343 5645. E-mail address: katherine.frohlich@umontreal.ca (K.L. Frohlich). 0168-8510/$ – see front matter © 2005 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.healthpol.2005.12.010