Who Thrives in Canada? Health, Prosperity, and Inequality Across Communities

Why It Matters

Without universal drug coverage and culturally competent care, Canada’s most vulnerable groups—racialized immigrants and women—remain stuck in lower well‑being, undermining the country’s health equity goals.

Key Takeaways

• Prescription drug costs sharply lower Canadians' life‑satisfaction scores
• Racialized immigrants report highest discrimination and lowest well‑being
• Women consistently score lower life satisfaction than men
• Language‑concordant doctors boost health outcomes and happiness for patients
• Social cohesion and trusted neighbors act as protective factors

Summary

The University of Toronto hosted a panel titled “Who Thrives in Canada? Health, Prosperity, and Inequality Across Communities,” featuring scholars from health, migration and gender studies. Professor Sonia Anand presented findings from the Canadian Alliance of Healthy Hearts and Minds, a national survey of 8,000 adults that measured life‑satisfaction using the Cantril ladder.

Statistical analysis identified three major negative predictors: inability to afford prescription drugs, high social disadvantage, and being a racialized immigrant, with women also reporting lower scores. Positive predictors included having a family doctor who speaks the patient’s native language and strong neighborhood social capital. Racialized immigrants averaged a 6.6 score, with only 57 % classified as thriving, and 64 % reported discrimination, especially Black newcomers citing skin colour.

Anand highlighted that Canada’s universal health system excludes prescription drug coverage, creating a “vicious cycle” for cardiovascular patients. She cited a 2022 CMAJ study showing 50 % higher hospital mortality for patients lacking language‑concordant physicians, underscoring the tangible health costs of linguistic barriers. The panel also noted that despite high education levels, racialized immigrants still experience lower well‑being, pointing to systemic rather than individual factors.

The findings suggest urgent policy reforms: expanding universal pharmacare, improving language‑concordant primary care, and investing in community cohesion initiatives. Addressing these structural inequities could raise national well‑being scores and narrow the gap between thriving and struggling Canadians.

Original Description

Although Canada performs well on aggregate measures of subjective well-being, national averages mask substantial heterogeneity across population groups. Professor Anand and her team’s analysis of data from the Canadian Alliance for Healthy Hearts and Minds cohort demonstrates that, while the majority of adults meet criteria for “thriving,” racialized immigrants report significantly lower life satisfaction compared with non-racialized, Canadian-born individuals. Thriving is independently associated with socioeconomic status, cardiovascular health, affordability of medications, neighbourhood social cohesion, and access to language-concordant primary care. Conversely, social disadvantage, poorer health, and barriers to care are associated with lower well-being. These findings underscore the importance of incorporating social determinants and health system factors into population health strategies aimed at reducing inequities in subjective well-being in Canada.

Co-Sponsor: Harney Program in Ethnic, Immigration, and Pluralism Studies Co-Sponsor: Mary Heersink School of Global Health & Social Medicine, McMaster University