Canada - World Health Organization Regional Office for Europe

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Health systems in transition Canada
2.9 Patient empowerment
2.9.1 Patient information
Most patients in Canada rely heavily on information provided by their health
care providers, in particular their family physicians as well as the specialist
physicians to whom they are referred. This information and advice is
supplemented by information provided by health care organizations, including
hospitals, RHAs and province-wide programmes, particularly for the prevention,
diagnosis and treatment of cancer. In the case of cancer, almost all provinces
have patient navigation programmes. In some provinces, such as Nova Scotia
and Quebec, cancer care navigators, most of whom are nurses, must have a
minimal level of experience to be certified (Wackinshaw, 2011; Pederson &
Hack, 2011).
The Canadian Council on Literacy defines health literacy as the ability to
obtain, understand and use health information. According to Simach (2009),
health literacy is a strong predictor of health status. Based on an International
Adult Literacy and Skills Survey of 23 000 Canadians using the Health Activities
Literacy Scale, which assesses literacy in terms of health promotion, health
protection, disease prevention, health care maintenance and system navigation,
roughly 60% of Canadians lack the capacity to obtain, understand and act on
health information and services to make appropriate health decisions (Canadian
Council on Learning, 2007). Immigrants, particularly those who come from
countries where the cultures and health systems differ greatly from those in
Canada, as well as new immigrants whose first language is neither English nor
French, have even lower health literacy than the already low Canadian mean
(Ng & Omariba, 2010).
There is a modest amount of accessible information on the quality of health
services in Canada. Since its creation in 2003, the Health Council of Canada
(HCC) has produced a number of reports, videos, podcasts and electronic
newsletters aimed at the general public. The HCC has also focused on issues
of patient and citizen engagement, including the engagement of Canadians in
their own primary health care (HCC, 2011b). Although provincial health quality
councils were established mainly to provide health ministries and RHAs with
systematic advice on quality improvement, they have also served to inform
the public on key aspects of health care. In recent years, provincial ministries,
quality councils and other organizations have provided more information to the
public on issues of great public interest including surgical waiting times and
hospital report cards. Historically, Canadians received little direct information