THREAD: I'm often asked whether the #SDoH & upstream inequities impact people later in life, when they are in need of #palliativecare & end-of-life care. A newly updated @HQOntario report paints a vivid picture.

#cdnhealth #onhealth #hpm #medtwitter

https://www.hqontario.ca/System-Performance/Specialized-Reports/Palliative-Care-Report

1. Regardless of how sick you may be in #Ontario, your income status (a vital #SDoH), majorly influences whether or not you receive #PalliativeCare, if at all.

See figure below

2. People near the end-of-life who are living in higher-income neighbourhoods are more likely to receive a home visit from a doctor during their final 30 days of life.

32.1% in wealthiest vs 20.8% in poorest neighbourhoods

3. People living in higher-income neighbourhoods are also
more likely to receive home care to help them remain comfortable & address their needs.

Any home care: 55.8% vs 47.2% in poorest neighbourhoods

Palliative-specific: 29.2% vs 21.2% in poorest neighbourhoods

4. Meanwhile, there has been little change over recent years in the proportions of people who receive publicly funded palliative-specific or any home care in their last month of life. Further, rates of home visits in the last month of life has slowed.

See figure below

5. Yet, this data does not reflect those experiencing structural vulnerabilities (eg homelessness, extreme poverty, substance use, trauma, social isolation, mental illness) in need of #palliativecare. So then, how many more are falling through the cracks in our communities?

6. The inequities that stem from the #SDoH surely impact people's lives, but they also accumulate at the end-of-life.

Death is most certainly a social justice issue.

Until we start seeing #palliativecare through the lens of #healthequity, little will change.

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