Clinical Care Resources - Poverty

Poverty among older adults is a social and fiscal problem associated with economic vulnerability.(5)  Canada uses low-income cut-offs (LICO) as an indicator for economic vulnerability.(2) Low-income seniors tend to be not only “income poor” but also “asset poor.” (3)

Why is it important?

  • Poverty among older adults in Canada is around 6.7% (5)
  • Poverty is associated with increases in cardiovascular disease, diabetes, mental illness, some cancers, hypertension,arthritis, COPD, and multiple chronic conditions

Common Causes

  • Single individuals are 4 times more likely to be poor than individuals living in families (1)
  • Older women tend to have lower incomes because wages were inferior when employed and since, on average, they live longer- they are at greater risk of using up savings (2)
  • Women who are divorced have lower retirement incomes than single women or widows because most do not claim a portion of former spouse’s pension (2)
  • Disabled seniors, Aboriginals, recent immigrants, and those who have worked less than 10 years are also at risk of poverty (2) (3)

Key Considerations

  • Income inequality among seniors is growing: since many seniors live on fixed incomes right above the poverty threshold, a small change in expenses or income can have a large impact on poverty rates and quality of life (1)
  • Low-income seniors spend close to 60 % of their expenditures on food and housing, transportation and health-related costs (3)
  • Personal income taxes and government transfers (such as social assistance and Old Age Security), Guaranteed Income Supplement payments and pension plans have helped to reduce elderly poverty (5)

Address poverty in primary care: (4)

  • Screen: screen everyone, “do you have difficulty making ends meet at the end of the month?”
  • Adjust risk: poverty is associated with increases in cardiovascular disease, diabetes, mental illness, some cancers, hypertension, arthritis, COPD,  and multiple chronic conditions
  • Intervene: ask the important questions
    • Do you receive Old Age Security and Guaranteed Income Supplement?
    • Have you filled out and mailed your tax forms? (tax returns are essential to access many income security benefits e.g. GST / HST credits, working income tax benefits, property tax credits and drug coverage forms such as Extended
    • Health Benefits or Trillium for those without Ontario Drug Benefits)
    • Do you receive payments for disability? (Eight major disability programs: ODSP, CPP Disability, EI, Disability Tax Credit, Veterans benefits, WSIB, Employers’ long term protection, Registered Disability Savings Plan)
    • Are you status Indian? (First Nations with the Status designation may qualify for Non-Insured Health Benefits through the federal government. These pay for drugs and other extended health benefits not covered by provincial plans)
    • Have you applied for extra income supplements?
    • Mandatory Special Necessities Benefits (MDs bill K054 for $25): Medical supplies and health related transportation (includes e.g. AA, psychotherapy)
    • Limitation to Participation (MDs bill K053 for $15): Disability can exclude a recipient from mandatory job search and training programs.
    • Special Diet Allowance (MDs bill K055 for $20): some health conditions will qualify a recipient for extra income.
    • Other benefits available: Employment supports, Drug & Dental, Vision, Hearing, ADP Co-payment,
    • Community Start Up & Maintenance, Women in Transition/Interval Houses, Advanced age allowance, Community Participation ($100 per month extra for volunteering
    • “Discretionary Benefits” Applications and benefits available through a patient’s OW/ODSP worker


1. Citizens for Public Justice. (2012). Poverty Trends Scorecard. Retrieved March 19, 2014 from:

2. National Advisory Council on Aging. (2005). Aging in Poverty in Canada. Retrieved March 19, 2014 from:

3. National Seniors Council. (2009). Report of the National Seniors Council on Low Income Among Seniors.
    Retrieved November 27, 2018 from:

4. Ontario College of Family Physicians. (2013).  Poverty: A Clinical Tool for Primary Care in Ontario.
    Retrieved March 19, 2014 from:

5. The Conference Board of Canada. (2013).  Elderly Poverty.  Retrieved March 19, 2014 from: