While Canada is an industrialized nation with one of the world’s best public health systems, there are disparities in access to healthcare. Those living in the country’s most populous areas have access to an array of services, including hospitals, care facilities, and specialized clinics. However, residents of northern and remote communities are less well-served. The reason is that these services are primarily located in the nation’s most densely-populated urban centres. Go here to learn more about how these disparities are being addressed.
In recent years, a movement has been underway to revitalize remote and northern Canadian communities by moving these services into the community. These services include telemedicine and remote working, which can be facilitated by high-speed Internet. But while connectivity has improved since the release of the government’s Connectivity Strategy in 2019, this does not extend to rural and remote communities, and it is unaffordable for many people living on First Nations reserves.
The disparity between those with and without affordable connectivity is also exacerbated by the fact that the availability of these services is not equally distributed. Although the vast majority of households in urban areas have high-speed Internet, this number falls to just 59.5 per cent for households in rural and remote communities and 42.9 per cent on First Nations reserves. The cost and quality of Internet and mobile cellular services is a barrier to full participation in the digital economy, especially for those who live on First Nations reserves.
It is too soon to know what impact, if any, the COVID-19 pandemic will have on these structural drivers of place-based health disparities in Canada, but it is worth taking a closer look at several trends. The first is the increasing demise of northern and remote communities.
Another trend is that more and more young people are choosing to leave their rural home bases in favour of urban living, attracted by opportunities such as jobs in the knowledge economies and better access to amenities such as music and theatre. Some even suggest that this “urban flight” will help to rejuvenate rural and remote areas by bringing young people back to their hometowns for work and leisure activities.
In an effort to categorize these communities, Statistics Canada recently developed a new remoteness index (RI) that assigns a relative remoteness value to each of the census subdivisions (CSDs). The RI categories are more precise than those used by other geographic classification methods (such as POPCTRs), which straddle provincial boundaries. The RI is a useful tool to identify and examine the characteristics of different parts of Canada, including its health-related factors. In this article, we apply the RI to examine how avoidable mortality rates vary by rurality/remoteness. This information is used to develop recommendations for improving health outcomes for northern and remote Canadians. This paper is based on research funded by the Social Sciences and Humanities Research Council of Canada.