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The impact of inequality on health in Canada: a multi-dimensional framework

This paper argues that a truly critical understanding of health inequality requires an analytical approach that acknowledges the interactional and interdependent relationships between structural, institutional and everyday inequalities, and how theseinequalities are informed by the intersecting relationships between race, culture, gender, citizenship status, socio-economic status and other social factors to determine health outcomes, health access and quality of care. The influences of macro-structural forces and micro-situational events on health outcomes are issues that have largely been analysed independently in the literature. This paper presents a Canadian perspective on these issues. It argues for an analysis that characterises inequality in its circuitous, contextual, multi-layered and multi-dimensional forms by articulating health outcomes for racialised and other marginalised groups as the product of the convergence between the macro-structural forces ofdiscrimination that often occur within societal institutions and structures, and the micro-situational discriminatory events that occur between individuals in everyday life. Finally, the paper suggests that reducing and eliminating poor health outcomes for racialised groups requires inter-professional partnerships between physicians, psychiatrists and other mental health professionals, nurses, social workers, community and settlement workers and other professionals, whichwould enable professionals in diverse fields to share different skills at various levels to help clients at different points in their lives within diverse clinical and non-clinical settings.

Author(s): Ingrid RG Waldron

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