Gabriolans learn what social determinants can create health risk

Derek Kilbourn

Sounder News

Tuesday, November 28 2017

On November 15, the Gabriola Health and Wellness Collaborative held a discussion involving a wide variety of Gabriola islanders, around the big picture topic of health and wellness on the island.

The keynote speaker was Paul Hasselback, Medical Health Officer with Island Health.

His topic was understanding the impact of the “social determinants of health” here on Gabriola Island.

As Hasselback explained, we’re pretty good at understanding what it means to have a disease, and what the risk factors are. 

Heart disease, cancer, stroke, arthritis, depression. These are what we typically think of when we think disease or illness.

Then there are the risk factors such as tobacco, alcohol, diet, physical fitness and social fitness.

Hasselback said, “I can’t think of a healthier place than Gabriola. But there are other challenges.”

These challenges are what can be looked at when we talk about determinants of health.

Economic status, education, work life, environment, social support, genetics, gender, child life, culture, lifestyles and coping, and health services - all of which can be part of determining the health and wellness of a particular individual.

Hasselback said, “Access to education. Many of you came here with education. Opportunities for education [for those raised here] is an issue. 

“Housing is a significant issue. 

“Poverty is a bigger issue than I think many of you think it is.”

“We can’t talk about health until we have the prerequisites in place. If you don’t have the fundamental things in place, you’re not even worried about health.”

And according to Hasselback and the information provided through the Health and Wellness Collaborative, not everyone living on Gabriola could say all the prerequisites are in place. 

“Do take that away. Domestic violence is an issue. Income.

“Residents of the island are challenged. Equity and social justice? That’s something you’ll be challenged by.”

He did stress that while there are issues on Gabriola, “Things are not that bad here.”

Hasselback explained that health services account for about 25 per cent of the healthy status of a population.

“The majority of the contribution are from those health services associated with preventing disease.

Health services are one of the most expensive items to deal with, but they only account for 25 per cent of what actually determines and impacts people’s health and wellness.

If we make positive changes to the other 75 per cent, including determinants, we can improve the health of the community and lower the cost of doing so in the long run.

Hasselback said “our number one risk factor for illness and health is age. 

“If you really want to not have a problem, don’t age.”

Since everyone is aging, and since the older part of society is getting to represent more of the population, “we’re more likely to see the effects occurring.”

The good news is that deaths due to cardiovascular issues have gone down.

In 1950, there were 700 to 800 deaths per 100,000 a year in Canada due to cardiovascular issues.

That dropped down by a third by 2004.

“There’s lots of data out there. We have lots of data available, but rarely is the data we want in the format we want.”

Dialing down to Gabriola, Hasselback said the total population hasn’t changed here much in a decade. Nanaimo’s population growth rate has been 1.5 per cent.

What has changed is the age spread.

“There has been a huge increase in the population over 65. Not just because of aging in place - it is also the attraction of moving here - there is a large increase in that population.”

The over-65 population has seen a 40 per cent increase since 2011.

Conversely, there are only 300 youth (under 15), a 20 per cent reduction since 2011.

Median rent on Gabriola is $768/mo. In Nanaimo it is $919.

Some other statistics for Gabriola: 

• 32 per cent of families with children are led by a single parent. 

• Two-thirds of persons over 65 years of age are living in couples. Hasselback said, “That’s good. Couple situations are good for longevity.” 

• Half the persons over 15 are living in traditional married couples, another 16 per cent in common-law. 

• A quarter of the persons over 15 are living in single-income homes. Hasselback said, “That puts them at risk for social determinants.”

When it comes to income, Gabriola couples with children have an average household income of $75,520 per year.

Gabriolans in single-parent households have an average income of $34,000.

“That’s less than half that of families with two incomes. 

“They are at significant risk.”

24.9% of islanders are living in a low income situation. 

That’s a thousand Gabriolans.

In Nanaimo the proportion is 16.5 per cent.

Hasselback said, “Forty per cent of Gabriola kids are in a household situation that is considered to be low income.

“The highest proportion are those who have the least of the least. 

“There is a poverty issue here on the island - and a relative lack of health.”

One more statistic brought up by Hasselback, which caught the attention of many in the room, is that only 45 per cent of the income on the island comes from employment. 

In other words, less than half the “income” of the island comes from someone being paid for a job.

35% of the island income comes from non-employment market income (pensions, investments, et cetera).

20% of the income is coming from government transfers such as subsidies and transfers. 

“The fact that 20 per cent are government transfers and 35 per cent is non-employment, this would suggest that [the island economy] is a little bit at risk and potentially not sustainable.

“When you live on an island, everyone is part of that community. And everyone has to contribute to the solutions.”