Self-harm hospitalizations higher in poorer areas

People living in poorer neighbourhoods are at higher risk of being hospitalized for incidents of suicide and self-harm compared with those in the wealthiest neighbourhoods, but strong community care could help close the gap, a new report suggests.

Thursday's report on 15 health indicators from the Canadian Institute for Health Information focuses on inequity for two main areas:

• Self-injury hospitalization rates, such as for attempted hanging, drug overdoses and cutting.
• "Ambulatory-care sensitive illnesses," such as Type 2 diabetes.

"If everybody had the same hospitalization rates as those in the highest income levels, you could reduce hospitalizations for self-injury by about 27 per cent and over 30 per cent for the ambulatory-care sensitive conditions like diabetes and heart disease," Kira Leeb, the institute's director of health system performance, said in an interview.

"So what that tells us is that the programs that need to be in place need to be targeted at aspects of the population, not necessarily a broad brush approach."

For self-injury for example, 70 per cent of those who are hospitalized also have a diagnosis of mental illness.

Highlighting the warning signs of self-injury in schools and increasing awareness and access to community care might reach people before the critical point that it requires hospitalization, Leeb said. She noted that being hospitalized for self-injury often means it was not adequately cared for in the community.

More than 18,400 Canadians, or about 67 per 100,000, were hospitalized for self-injury in 2011-12, the institute reported. 

Self-injury hospitalization rates were highest in Newfoundland and Labrador and New Brunswick, at 86 and 85 per 100,000, respectively. They were lowest in Ontario, Alberta and Quebec (63, 59 and 59 per 100,000, respectively), but those provinces also showed room for potential improvements.

The report highlights areas where planners could focus their health promotion and prevention efforts, Leeb said.

In total, the report included more than 40 measures of health and health system performance in Canada for the provinces and territories, as well as for the country's larger health regions.

Neighbourhoods were divided into five categories to group people by socio-economic status because there's a correlation between where a person lives and the "social determinants of health" such as income, education, crime rate and quality of community services.

This year, the Canadian Medical Association is also focusing on social determinants of health and the role of doctors in promoting health equity. The goal is for individuals to reach their full health potential without social and economic conditions undermining it.