Chapter 4: The Chief Public Health Officer's report on the state of public health in Canada 2008 – Education and literacy
Social and Economic Factors that Influence Our Health and Contribute to Health Inequalities
Education and literacy
Generally, being well-educated equates to a better job, higher income, greater health literacy, a wider understanding of the implications of unhealthy behaviour and an increased ability to navigate the health care system – all of which lead to better health. The data in Chapter 3 indicate that Canadians with lower levels of education often experience poorer health outcomes, including reduced life expectancy and higher rates of infant mortality. Similarly, a recent U.S. study found much higher early mortality rates among lower-educated populations compared to more educated populations. This study estimated that if all adults had the same mortality rate as those with the highest education, then the potential reduction in premature mortality (or early death) would be equivalent to eight times the number of deaths averted by medical advances over the same period.309
Completing high school can help improve quality of life for young people by providing them with the tools and confidence they need to lead healthier, more productive and prosperous lives that benefit them as individuals and, in turn, benefit their communities. Across the country, over 17 million Canadians are high school graduates – about 80% of Canadian adults over the age of 25.310 This puts Canada among the top five OECD countries in terms of high school completion rates.311 There are, however, regional differences: British Columbia residents have high school completion rates that are higher than the Canadian average, while those in Quebec and the Atlantic regions fall below the average.310 First Nation populations also have lower levels of education than the Canadian average, with just under half having graduated from high school.161
In Canada, the high school dropout rate has decreased since the 1990s to 10% among 20- to 24-year-olds.312 Despite this improvement some young Canadians continue to remain at risk of quitting school prematurely, especially disadvantaged youth who lack the supports they need to reach their full potential. Compared to Canadians who complete high school, those who drop out are: more likely to receive social assistance and unemployment payments; more likely to become jailed; more prone to illness and injuries; and more likely to have poor knowledge about health behaviours.313 They are also less aware of and less apt to use preventive health services and less likely to participate (e.g. volunteer) in community activities.314
Differences are found between men and women and their participation in post-secondary education. The number of women who hold a university degree has risen sharply (21% in 1991 to 34% in 2001), whereas the number of men who hold a university degree has increased at a lesser rate (16% in 1991 to 21% in 2001).318 It is also notable that the gap between the proportion of men and women enrolling in post-secondary education is increasing. Women, who have been traditionally under-represented at post-secondary institutions, now account for six out of ten undergraduates at Canadian universities.319 Considering the influence of education on health, a health gap related to lower education levels among men may emerge if males continue to be under-represented in higher education.
Education and income are often inter-related in terms of their impacts on health. Median earnings by education level attained indicate that the higher the education obtained, the higher the average earnings (2001). In fact, those with a university-level diploma/certificate earn, on average, more than twice the income ($48,648) of those who have not completed high school ($21,230).320 Although more women are now pursuing a post-secondary education in comparison to men, their average full-time employment wage has not increased proportionately.318 The wage gap between men and women has only decreased by 2% (from 20 to 18% between 1991 and 2001) for full-time employment wages.318
In general, there is a correlation between levels of education and literacy where the more educated a person, the more likely he or she is to have a comparable ability to read and comprehend written material. The term ‘literacy’ is now understood to include not only the ability to read, write and calculate, but also to understand and apply learned information in everyday life activities and decisions. Illiteracy can have a direct impact on health, for example, through the incorrect use of medications or safety risks associated with the misuse of potentially hazardous chemicals in the home or workplace.
About nine million Canadians (42% of those aged 16 to 65 years) perform below the literacy level considered the minimum necessary to succeed in today’s economy and society.314 The statistics are even more troubling for certain groups, including seniors, immigrants and Aboriginal Peoples.
Enhancing Opportunities for Education
Pathways to Education
Regent Park, located in the centre of Toronto is considered Canada’s most economically disadvantaged public housing project. The community has limited infrastructure and resources, and, until recently, offered few reasons for youth to hope for a better future. Over 80% of residents are visible minorities and for 60% English is a second language.315 The neighbourhood has the highest concentration of low-income families in Toronto and twice the number of single-parent families as the rest of the city. With no secondary school in the community, 56% of the area’s high-school age kids dropped out of high school in 2001 – twice the Toronto average.316 That same year, the Regent Park Community Health Centre decided to step in and take action. They believed that today’s Regent Park youth could become tomorrow’s leaders – so they created Pathways to Education to break the cycle of poverty and increase the chances that youth would complete secondary school and carry on to post-secondary education.315 The program provides academic, social, financial and advocacy supports to at-risk and economically disadvantaged youth, including access to tutors, career mentors, student-parent support workers, free transit tickets to get to and from school (tied to attendance), and bursaries for college or university for all students who go on to accredited post-secondary programs.317 A recent independent evaluation of the program found that:
The Pathways to Education Program is now being expanded to five other communities, with plans to reach more than 20 communities across Canada.315
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