Poverty Increases Post-Surgery Death Risk, Canadian study Finds
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A new cohort study of over a million patients in Ontario reveals that individuals from disadvantaged neighborhoods face a substantially higher risk of dying within 30 days of elective surgery compared to those from wealthier areas, highlighting the enduring impact of social determinants of health on medical outcomes.
A groundbreaking study, published in the medical journal JAMA, demonstrates that despite advancements in surgical care, nearly 2% of patients still die within a month of undergoing planned procedures – a rate that has remained stagnant over the past decade. The research confirms what many healthcare professionals have long suspected: where a patient lives profoundly impacts their chances of survival, even within a worldwide health care system like Canada’s.
Disparities Persist Despite Universal Access
The Ontario study found that patients from the most disadvantaged neighborhoods had a 52% increased risk of death following surgery compared to those from the wealthiest areas. This disparity remained critically important even after researchers accounted for pre-existing health conditions like cancer,heart failure,diabetes,and hypertension,as well as demographic factors,hospital variables,and the complexity of the surgical procedures themselves.
“It is a major contribution of the study to put a figure, to quantify this association,” noted a sociologist researcher at the Observatoire québécois des inégalités. “We need this kind of data.” The findings echo research from countries with private, for-profit healthcare systems, suggesting that the influence of social factors on health outcomes is not unique to any single model of care.
Quebec faces Similar Challenges
While the study focused on Ontario patients between 2017 and 2023, experts believe the situation is likely comparable in Quebec. “Nothing suggests that it would be very different for Quebec patients,” the researcher stated, adding that recent data indicates a growing number of people in precarious situations within the province. “I have no reason to think that it is different in Quebec.”
The researcher explained that material and social deprivation can lead to delays in seeking medical attention. Individuals facing financial hardship may postpone care until a problem becomes severe, or even forgo treatment altogether, due to factors like inflexible work schedules or limited time off. “It’s all these little things that ultimately mean that when we live more in a situation of disadvantage,we will have less access to the health care system.”
Addressing root Causes is Key
The study underscores the need to address the underlying social determinants of health to improve postoperative outcomes.These determinants encompass the conditions in which people are born, grow, work, live, and age. According to a document from the Observatory of Quebec Inequalities, those with fewer resources often struggle to meet basic needs like food and housing, increasing their vulnerability to illness and potentially leading to reduced spending on essential medications. Poverty also contributes to chronic stress and mental health challenges.
The researcher emphasized that the most effective solution would be to ensure everyone can afford their basic needs. “This requires better financial support, but it can also involve neighborhood improvements,” she said. “It is indeed to allow people to be independent to be able to buy food that is sufficient and of quality; to be able to find decent housing; to be able to dress yourself… These are the essential basic needs.”
While acknowledging that systemic change will take time, the researcher stressed the cumulative impact of social inequalities on health. “The causes of health problems are multifactorial and have a cumulative effect, and social inequalities are one of them.” Addressing these inequalities is not a quick fix, but a crucial step towards a more equitable and effective healthcare system for all.
The Canadian Press’s health coverage is supported by a partnership with the Canadian Medical Association. The Canadian Press is solely responsible for this journalistic content.
