Author: Sabin Ghimirey
Whenever I ask my parents or family friends for their reasons for moving to Canada, quality universal healthcare is cited as one of the primary reasons why. Interestingly, I have lived all my life in Toronto and the quality of healthcare has been adequate, so it is easy to see why my parents made their choice to settle here. This notion is valid for many of us but upon further analysis, it only holds for provinces such as British Columbia and Ontario. This is demonstrated by the comprehensive 2015 conference board of Canada’s provincial and territorial health report card, which displays a disparity in health outcomes within different regions of Canada. This report used eleven health indicators such as life expectancy, infant mortality, and mortality due to cancer amongst others to gauge health outcomes. It showed that these two provinces were top ranked on health while worryingly, regions with higher proportions of aboriginal people such as Manitoba, Saskatchewan, and the territories were the worst-ranking on the overall report. Specifically, Nunavut ranks last. The difference in health outcomes is heavily pronounced in comparison to the rest of Canada. Although a plethora of reasons exist for this difference, they can be narrowed down to a lack of healthcare infrastructure, food security, and mental wellness.
The problems with food insecurity, poor nutrition, the high cost of store-bought foods, the high suicide rates, and poor mental health are sadly well known. However, a relatively shrouded issue at the root of many of these problems is the high turnover of health providers. Like many remote regions, the healthcare system in Nunavut relies on a supply of short-term physicians and nurses coming from outside the territory. This is demonstrated thoroughly by an analysis done by the Qaujigiartiit Health Research Centre and the Nunavut Department of Health, which showed that between 2014-2016, half of the physicians working in Nunavut were on 20-day contracts. This naturally begs the questions: why is there trouble in retaining healthcare workers, what are the consequences, and what is being done about it?
To begin, the high costs of living, having to work in isolated communities for prolonged
periods away from home, and lack of job opportunities for the worker’s partners are some of the barriers to retention. This leads to the deterioration of quality of care as patients need to repeat their symptoms to new physicians often leading to discouragement for follow-ups. Broadly speaking, this high turnover rate has led to inconsistencies in the quality of service, poor communication between different providers leading to medication errors, and affecting the efficiency and morale of the providers themselves. Furthermore, there is a lack of cultural orientation for the workers leading to a lack of culturally competent care creating more barriers.
The high turnover rates of healthcare providers are having an impact on health outcomes and reinforcing the grades Nunavut received on the 2015 conference board of Canada’s provincial and territorial health report card. Currently, work is being done to train and hire Inuit and northern nurses who want to stay in their communities, and many initiatives are being undertaken to encourage more students to work in rural communities. While Canada guarantees universal healthcare to all its citizens, it fails to ensure the quality of care remains the same throughout its vast regions and has ways to go to ensure similar health outcomes for its people.
References
https://www.conferenceboard.ca/hcp/health
aspx/#:~:text=Newfoundland%20and%20Labrador%2C%20the%20worst,%E2%80%9CD%E2
%80%9D%20grades%20on%20health.
https://www.itk.ca/wp-content/uploads/2016/07/ITK_Social_Determinants_Report.pdf
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6443525/
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