The evidence in this report indicates that inequalities are persistent in Canada. Over the past decade, little or no progress has been made in reducing inequalities in health by income level in Canada (please see the appendix). Since the early 2000s, inequalities have widened for 3 of the 16 health indicators that were studied and did not change for 11 of them. While inequalities did narrow for the remaining 2 indicators, this was the result of an undesirable “levelling down” effect — in other words, health worsened among the richest Canadians while at the same time there was no change among the lowest income group.