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A Discussion on the Determinants of Health in Canada with a Focus on New Brunswick (Part 2)

PART 2

NEW BRUNSWICK


(Special Benefits Insurance Services, n.d.)

(If you have not yet read Part 1, you can find it here)

In New Brunswick
New Brunswick is a small province of 747,101 residents as of 2016. (Statistics Canada, 2018). As the only official bilingual province in Canada, the province determined it to be necessary to have two health systems within itself that catered to the linguistic needs of its population. Horizon Health Network was established to provide healthcare services to mainly Anglophones (with bilingual capabilities) while the Vitalité Health Network provides services to Francophones.
According to their respective websites, “Horizon Health Network (Horizon) operates 12 hospitals and more than 100 medical facilities, clinics and offices throughout New Brunswick." (Horizon Health Network, n.d.).
“Vitalité Health Network is a regional health authority providing and managing health care and services in an area covering northern and southeastern New Brunswick. The Network is the only Francophone managed organization of its kind in the country and has nearly 60 points of service providing a range of health care and services to members of the public in the official language of their choice.” (Vitalité Health Network, n.d.).

Unfortunately, in recent times, the province has been plagued by a decreasing and aging population, with a reduction in population of almost 4000 persons between 2011 and 2016. Whereas, the overall population of Canada increased from 33,476,688 to 35,151,728 during that time. (Statistics Canada, 2018).Tony Tremblay states
 “New Brunswick’s status as a “have-not” province—a province that receives equalization payments from wealthier “have” provinces to offset its fiscal incapacities—means that its ability to meet the goal of universality as outlined in the Canada Health Act is especially challenging…The implications of this fact in New Brunswick and other have-not provinces for physician and medical staffing, infrastructure and equipment costs, health education and research, and other aspects of health, widely defined, are staggering. Provinces with the fewest resources are expected to deliver services that are the equivalent of provinces with the most.” (Tremblay, 2017).

For a province with limited resources, mostly rural communities and a higher than average elderly population, the effects on overall health have proven significant. In a paper published in the Journal of New Brunswick Studies, Paul Peters shows “Provincially, New Brunswick fares poorer than the national average on several key population and health indicators: post-secondary graduates, long-term unemployment, reliance on government transfers, high and growing old-age dependency, total age-standardized mortality rate, self-perceived health, proportion of overweight and obese, diabetes, and ACS conditions.”(Peters, 2017).
However, it is important to note that within the province itself, larger cities like Fredericton, Saint John and Moncton (and their surrounding areas) were overall deemed to have better health based on the determinants evaluated, including self-perceived health.

In my opinion, perhaps this gives us an idea as to why New Brunswick (as well as the other Atlantic provinces) seems to be unhealthier than larger provinces like Ontario and Alberta despite those provinces having far larger and more diverse populations. Just as larger cities within the province have been determined to have better overall health and smaller ones.

It seems that education and economic status, technology, social and physical environments and other determinants that vary differently between urban and rural communities do account for a better determination of health.

References
Horizon Health Network. (n.d.). About Us. Retrieved from http://en.horizonnb.ca/home/about-us.aspx

Peters, P. (2017). Population Change and Population Health: A Spatio-temporal Analysis of New Brunswick Communities.Journal of New Brunswick Studies / Revue d’études sur le Nouveau-Brunswick, 8. Retrieved from https://journals.lib.unb.ca/index.php/JNBS/article/view/25881/30033

Special Benefits Insurance Services. New Brunswick Health Insurance [Image]. Retrieved from https://www.sbis.ca/new-brunswick-health-insurance.html

Statistics Canada. (2018). Census Profile, 2016 Census. Retrieved from https://www12.statcan.gc.ca/census-recensement/2016/dp-pd/prof/details/Page.cfm?Lang=E&Geo1=PR&Code1=13&Geo2=&Code2=&Data=Count&SearchText=New%20Brunswick&SearchType=Begins&SearchPR=01&B1=All&GeoLevel=PR&GeoCode=13

Tremblay, T. (2017). Health Care in New Brunswick: The Elephant in the Room (as if we needed another elephant). Journal of New Brunswick Studies / Revue d’études sur le Nouveau-Brunswick, 8. Retrieved from https://journals.lib.unb.ca/index.php/JNBS/article/view/25875/30021

Vitalité Health Network. (n.d.). Who are we. Retrieved from https://www.vitalitenb.ca/en/who-are-we



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