Open Access Open Badges Research

Public awareness of income-related health inequalities in Ontario, Canada

Ketan Shankardass12*, Aisha Lofters13, Maritt Kirst14 and Carlos Quiñonez15

Author Affiliations

1 Centre for Research on Inner City Health, St. Michael’s Hospital, Toronto, ON, Canada

2 Department of Psychology, Wilfrid Laurier University, 75 University Avenue, Waterloo, ON, N2L 3C5, Canada

3 St. Michael’s Department of Family & Community Medicine, University of Toronto, Toronto, ON, Canada

4 Ontario Tobacco Research Unit, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada

5 Faculty of Dentistry, University of Toronto, Toronto, ON, Canada

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International Journal for Equity in Health 2012, 11:26  doi:10.1186/1475-9276-11-26

Published: 21 May 2012



Continued action is needed to tackle health inequalities in Canada, as those of lower income continue to be at higher risk for a range of negative health outcomes. There is arguably a lack of political will to implement policy change in this respect. As a result, we investigated public awareness of income-related health inequalities in a generally representative sample of Ontarians in late 2010.


Data were collected from 2,006 Ontario adults using a telephone survey. The survey asked participants to agree or disagree with various statements asserting that there are or are not health inequalities in general and by income in Ontario, including questions pertaining to nine specific conditions for which inequalities have been described in Ontario. A multi-stage process using binary logistic regression determined whether awareness of health inequalities differed between participant subgroups.


Almost 73% of this sample of Ontarians agreed with the general premise that not all people are equally healthy in Ontario, but fewer participants were aware of health inequalities between the rich and the poor (53%–64%, depending on the framing of the question). Awareness of income-related inequalities in specific outcomes was considerably lower, ranging from 18% for accidents to 35% for obesity.


This is the first province-wide study in Canada, and the first in Ontario, to explore public awareness on health inequalities. Given that political will is shaped by public awareness and opinion, these results suggest that greater awareness may be required to move the health equity agenda forward in Ontario. There is a need for health equity advocates, physicians and researchers to increase the effectiveness of knowledge translation activities for studies that identify and explore health inequalities.

Health equity; Health inequalities; Public opinion; Public awareness; Media; Political will