Medical Council of Canada

Medical expert

Health of Special Populations - 78-7


Health equity is defined as each person in society having an equal opportunity for health. Each community is composed of diverse groups of individuals and sub-populations. Due to variations in factors such as physical location, culture, behaviours, age and gender structure, populations have different health risks and needs that must be addressed in order to achieve health equity. Hence physicians need to be aware of the differing needs of population groups and must be able to adjust service provision to ensure culturally safe communications and care.

Key Objectives

  • Understand how variation in the determinants of health in different populations promotes or harms their health status.
  • Discuss how populations may have challenges with respect to access to health services, and how members of the population may rely on traditional or alternative sources of health services that are not commonly used by society as a whole.
  • Discuss the implications of the different cultural perspective and how this affects the planning, delivery and evaluation of services (both preventive and curative).
  • Discuss how to provide culturally safe care with different populations.
  • Discuss the unique roles provided by government, social agencies, or special groups (e.g. Indigenous health centres, Traditional healers) in providing services to the population.

Enabling Objectives

First Nations, Inuit and Métis peoples are the original inhabitants of Canada. Collectively, they have a special relationship with the federal government due to their treaty status, and many historical events have had a strong impact on their health expectancy.

  • Describe the diversity amongst First Nations, Inuit, and/or Métis communities in your local area in terms of their various perspectives, attitudes, beliefs and behaviours. Describe at least three examples of this cultural diversity.
  • Describe the connection between historical and current government practices towards First Nations, Inuit, Métis peoples (including, but not limited to colonization, residential schools, treaties and land claims), and the intergenerational health outcomes that have resulted.
  • Describe how the medical, social and spiritual determinants of health and well-being for First Nations, Inuit, Métis peoples impact their health.
  • Describe the various health care services that are delivered to First Nations, Inuit, Métis peoples, and the historical basis for the systems as they pertain to these communities.

Increasing transportation of people, food and consumer goods is breaking down previous geographic boundaries. Diseases such as SARS can travel quickly around the world and events in other parts of the world affect medical practice in Canada. Canada is also dependent on new immigrants for growth with many locations having a very high proportion of new immigrants and refugees.

  • Identify the travel histories and exposures in different parts of the world as risk factors for illness and disease.
  • Appreciate the challenges faced by new immigrants in accessing health and social services in Canada.
  • Appreciate the unique cultural perspective of immigrants with respect to health and their frequent reliance on alternative health practices.
  • Discuss the impact of globalization on health and how changes in one part of the world (e.g. increased rates of drug-resistant Tuberculosis in one country) can affect the provision of health services in Canada.

Persons with physical, mental, or sensory disabilities have unique needs and may require health and social services to be provided in alternative ways.

  • Identify the challenges of persons with disabilities in accessing health and social services in Canada.
  • Discuss the issues of stigma and social challenges of persons with disabilities in functioning as members of society (link to mental health).
  • Discuss the unique health and social services available to some persons with disabilities (e.g. persons with Down's syndrome) and how these supports can work collaboratively with practicing physicians.

Homeless persons have unique needs due to their physical lack of basic shelter and ability to bath and prepare food safely. In addition, being homeless is associated with many other conditions such as mental health and may require health and social services to be provided in alternative ways.

  • Identify the challenges of providing preventive and curative services to homeless persons.
  • Discuss the major health risks associated with homelessness as well as the associated conditions such as mental illness.

The elderly and very young children both share the challenges of being at high risk for certain medical conditions (e.g. Hemolytic Uremic Syndrome) as well as being very vulnerable to changes in the determinants of health. For example, children living in poverty or poor seniors living in isolation are both at high risk for adverse health outcomes.

  • Identify the challenges of providing preventive and curative services to isolated seniors and children living in poverty.
  • Discuss the major health risks associated with isolated seniors and children living in poverty.
  • Discuss potential solutions to these concerns.
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