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CMHA Ontario’s perspective on Health Care in Canada: What Makes Us Sick?

August 1, 2013

CMHA Ontario shares the concerns outlined in a new report by the Canadian Medical Association (CMA) about the impacts of inequities and the social determinants of health on the health of Canadians.

What Makes Us Sick Report CoverIn its July 30, 2013 study about Canadian perspectives on the social determinants of health, the CMA found that poverty and other socio-economic factors are making Canadians sick, with significant costs for communities and the health system. The report’s key findings are based on consultation with more than 1,000 participants across Canada, including six public town hall meetings and online discussions.  Participants identified four determinants as particularly relevant: income, housing, food security and early childhood development. Mental health was identified as a critical piece of the puzzle.  Structural racism facing Aboriginal communities was also highlighted as a key concern.

The report’s recommendations call on all levels of government to prioritize poverty elimination, affordable housing, food security, investments in early childhood education programs, access to medically necessary prescription drug therapies for all Canadians, and targeted investments for improving Aboriginal health. With respect to mental health, it is recommended that the Mental Health Commission of Canada’s “Housing First” strategy be continued and expanded across Canada.

CMHA Ontario is committed to ongoing research, policy and advocacy work to advance equity in mental health and has identified that:

  1. Equity matters to mental health – The social determinants of health, which contribute to inequities, can contribute to poor mental health for Ontarians.  Poverty, discrimination, violence and social exclusion have been identified as particularly significant for mental health.
  2. Mental health matters for equity – People with lived experience of mental health issues can experience a range of inequities including stigma, discrimination and social exclusion that further impact the social determinants of health, such as access to employment or housing.
  3. Intersectionality matters – Many individuals experience both mental health issues and other inequities, such as poverty or racialization.  Overlapping or intersecting experiences of mental health issues and other inequities deepen and reinforce one another, creating additional challenges at the individual, service delivery and health system level.

CMHA Ontario is taking action to address these issues. For example:

  • CMHA Ontario is increasing the capacity for the community-based mental health sector to develop nutrition and food security programming with partners in these fields. Through the Minding Our Bodies project, innovative mental health promotion programs in nutrition and food security have incubated at the local level in collaboration with community partners, with knowledge gained from the project shared across the mental health sector.
  • CMHA Ontario is addressing poverty reduction and access to other economic resources through policy work and partnership with other community agencies. In addition, CMHA Ontario plays a lead role in the Mental Health Employment Supports Network, which helps inform provincial policy changes with the goal of increasing access to education and employment opportunities for persons with mental health conditions.
  • Through CMHA Ontario’s work with the Community of Interest for Racialized Populations, policy makers and other mental health system stakeholders have increased understanding of the links between mental health issues, racialization and emergency department use. Through consultations with service users and providers, this project identified that increased emergency department use by people with lived experience of mental health issues and racialization were associated with major life changes related to the social determinants of health such as income or housing.

For more information about CMHA Ontario’s work, please visit the current issues section of our website.

To read the Canadian Medical Association report, What Makes Us Sick?, please visit the CMA website at

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