The World Health Organization in Europe published a document entitled The Social Determinants of Health. In this document, ten determinants of health were presented along with evidence that these things largely dictate longevity and quality of life of individuals and populations. The determinants of health, according to this document are: the position of individuals or groups on the social gradient, the amount of stress experienced, quality of early life, the amount of social exclusion experienced, the quality of work available, the level of unemployment in the population, the social supports available, prevalence of addiction, quality of food available, and the quality of accessible transport. Furthermore, the document suggested that the presence or absence of the determinants of health have great effect on mental health and productivity of individuals.

In Canada there is a large discrepancy between poverty levels in aboriginal populations compared to other groups which live in Canada. If a few of the determinants of health are examined, it is evident that there is a very large difference between the aboriginal communities and the rest of Canada's population. These differences can be illustrated through some of the statistics which have been gathered regarding the status of Canada's aboriginal population over the last ten years. For example, 52.1% of aboriginal children in Canada live in poverty; this is nearly double the average for all of the children in Canada combined. Aboriginal youths between 15 - 24 are almost twice as likely to be unemployed then the national average for the same age, and 46% of Aboriginal' s have an income less than $10 000 compared to 27% of non-Aboriginal people. Early life experiences, unemployment and job satisfaction are all determinants of health, and are areas that need attention in Canada's aboriginal population.

Last summer, I visited Garden Hill, an Aboriginal community located in northern Manitoba for a two-week medical exposure. Garden Hill is a very isolated community where all supplies must be flown in, except in the winter when unreliable ice roads allow for truck transportation. Limited access to this community results in the average cost of living being much higher then in communities which are not isolated. For instance, to feed a family of four in Garden Hill is costs more then 200% of what it would cost in Winnipeg, the capital city of Manitoba, located just a little more then 600 km south-west. When it is considered that nearly half of aboriginal people make less then $10 000 a year, and that there are especially high levels of unemployment in isolated aboriginal communities such as Garden Hill, it is easy to see how people of these communities may not be able to afford the things they need to eat properly, let alone to give their children the same advantages, both educationally and socially, as people who live in less isolated communities.

The World Health Organization has made it clear that poverty and poor health are linked, and these two things are directly related to the resources available to people. In Garden Hill and Canada's aboriginal population in general, it is evident that some of the important things which the World Health Organization has prescribed to have healthy populations and individuals are missing. These deficits need to be addressed by both the citizens and the government of Canada. For the World Health Organization has made it very evident that finding a solution to poverty is not the responsibility of those who live with it, but of those who can prevent it.

Maclean Thiessen is a second-year medical student at the University of Manitoba in Canada.