Sociocultural Factors: Opportunity Health care wait times are one of the largest problems in the Canadian health system. While Canadians are proud of their health care system, they report dissatisfaction with wait times as shown in the results of a 2012 survey by the EKOS Research Associates which found that 63% of Canadians are not satisfied with the availability of specialists and 65% are not satisfied with access to new diagnostic tests and treatments.1 A majority of Canadians have recognized long wait time as a serious social issue and believe that health care should be the main priority issue for government rather than other issues including economic and environmental issues.2 Public awareness of the health care wait time issues means that health care related charities do not need to convince the public that there is a problem that needs to be solved. The public is also aware that shortages of medical staff, supplies, and equipment are the main causes of increased wait times. Managing wait times is split between demand-side strategies (clinical priotization of patients on wait lists and auditing of wait lists) and the supply-side (increasing resources, equipment, and efficiencies3. Since the need for more resources and the need for specific medical equipment has clear and obvious benefits to the public and the media attention that has been paid to the impact of new equipment, medical charities do not need to spend significant resources making the case that donations are needed to help purchase equipment and services that will help reduce wait times.4 These factors are in the favour of medical charities and foundations and reduce the resources they need to spend on educating the public, allowing charities to spend more resources on raising funds to help cover funding shortfalls. Canadians are a generous people and usually rank among the top three most giving countries globally in individuals donations of time and money to charities.5,6,7 Statistics Canada found that in 2010 84% of Canadians donated a combined $10,609,533 to charitable or non-profit organizations, and in 2007 84% Canadians donated $10,429,330. Out of the 84% total donor percentage, 71% (2010) and 74% (2007) of donors made donations to charities or non-profits focusing on the health sector. This is a strong indicator that many Canadians are already taking actions to improve the health care system. However, Statistics Canada also noted that the percentage of Canadians giving to health-related charities or non-profit medical organizations declined by 4% between 2007 and 2010. Over the same period the total amount donated increased, indicating that fewer people were donating but the ones who did donate gave more.8 Table 1 shows key reasons people surveyed gave when asked why they give to charities and non-profit organization, and possible reasons for the decline in the number of Canadians giving. Table 1: Reasons people giving financial donations and potential reasons for decline in giving.

Reasons people giving Potential Reasons for decline in giving

Feel compassion toward people in need Declining income levels over the last decade.

Personally believing in the cause of organizations

Changing perceptions of charities among former donors

Personally affected by an organizations cause The scope of government involvement in activities traditionally provided by charities

Want to contribute to the communities The way of tax system operation

Has a relationship with a particular charity because of personal experience

A decline attachment of religious institutions

Religious obligations and beliefs

Income tax credit Sources: Statistics Canada, Chart 8 Reasons for making financial donations, donors aged 15 and over, 2007 to 2010, modified May 2, 2015, http://www.statcan.gc.ca/pub/11-008-x/2012001/c-g/11637/c-g08-eng.htm. Community Foundations of Canada, Research on Charitable Giving in Canada, accessed February 7, 2015, http://www.cfc-fcc.ca/pa-eresource/talking-about-charitable-giving/research-on-charitable-giving-in-canada.cfm.

CBC News, Canadian Generosity in decline with just 22.3% of tax filer giving to charity, http://www.cbc.ca/news/business/canadian-generosity-in-decline-with-just-22-3-of-tax-filers-giving-to-charity-1.2874987.

Although there is a concern over the decline in the percentage of Canadians giving financial donations to medical sector, health related charities or medical foundations stand to benefit from increased public awareness of issues with the health care system. The publics personal experience and the direct benefit the public sees in health care related donations means that health care charities will likely receive higher priority over other types of charities. Social media networks are a powerful tool for spreading ideas, messages, and news faster and wider. A good example of their power is the Ice Bucket Challenge campaign which was a campaign to raise funds for Amyotrophic Lateral Sclerosis (ALS) research which went viral. The nature of the fundraising pitch and the utilization of social media tools such as Facebook and YouTube allowed the campaign to spread rapidly by word of mouth and brought in funds from around the world.9 Although the Ice Bucket Challenge sparked lively debate over the pros and cons of fundraising efforts going viral, the campaign succeeded in promoting awareness of the disease and raised $115 million for the ALS Association.10,11 In Canada the ALS Ice Bucket challenge raised a total $16.2 million with more than 260,000 people contributing to the challenge.12 Canadians rank 1st in social media penetration in the world. The Canadian Digital Social and Mobile Statistics on a Global Scale 2014 showed,13

86% (26,263,000) of Canadians are internet users

91% of internet users have a social media account

66% of those with a social media account have used social media in the past month

55% of online Canadians (19,000,000) are active users of Facebook Social media networks offer charities and non-profit organizations the opportunity to spread their message widely and fundraise from a much larger pool of donors than traditional campaigns might reach at a much reduced cost. Overall, Canadians awareness of health care issue, their generous contributions to charitable or non-profit organizations, and their high social media network penetration level present a positive social environment for non-profit medical foundations or charities related to health care activities for the purpose of raising funds.

1. The Conference of Board of Canada, Canadians are Less Satisfied the Deeper They go Into the Health System, http://www.conferenceboard.ca/press/newsrelease/12-10-26/canadians_are_less_satisfied_the_deeper_they_go_into_the_health_system.aspx.

2. Daniel Muzyka, Glen Hodgson, and Gabriela Prada, The Inconvenient Truths About Canadian Health Care, The Conference of Board of Canada, http://www.conferenceboard.ca/cashc/research/2012/inconvenient_truths.aspx. 3 British Columbia Medical Association, Waiting Too Long: Reducing and Better Managing Wait Times in BC, https://www.doctorsofbc.ca/sites/default/files/waiting_too_long.pdf 4 Vancouver Coastal Health, New MRI coming soon to VGH, thanks to donation, http://www.vch.ca/about-us/news/news-releases/news-release-archive/2010-news-releases/new-mri-coming-soon-to-vgh,-thanks-to-donation

5. CBC News, Canadians generous charity donors, http://www.cbc.ca/news/canadians-generous-

charity-donors-1.901793. 6. Matthew Coutts, Canada ranks as third most-charitable country in new study, Yahoo! News Canada, https://ca.news.yahoo.com/blogs/dailybrew/canada-ranks-as-third-most-charitable-country-in-new-

165140773.html. 7. Charities Aid Foundation, World Giving Index2014 A global view of giving trends, 11,

https://www.cafonline.org/pdf/CAF_WGI2014_Report_1555AWEBFinal.pdf. 8. Martin Turcotte, Charitable giving by Canadians, 27, Statistics Canada,

http://www.statcan.gc.ca/pub/11-008-x/2012001/article/11637-eng.pdf. 9. Mirror Online, Ice Bucket Challenge, http://www.mirror.co.uk/all-about/ice-bucket-challenge. 10. Scott Gilmore, Why the Ice Bucket Challenge is bad for you, Macleans,

http://www.macleans.ca/society/health/why-the-ice-bucket-challenge-is-bad-for-you/. 11. Justin Worland, Heres Whats Happening With the Ice Bucket Challenge Money, Time Inc.,

http://time.com/topic/als-ice-bucket-challenge-2/. ngela Mulholland, Ice Bucket Challenge in Canada raised $16M, CTV News,

http://www.ctvnews.ca/health/ice-bucket-challenge-in-canada-raised-16m-1.2109152. 13. Melody McKinnon, Canadian Digital, Social and Mobile Statistics on a Global Scale2014,

Canadians Internet Business, http://canadiansinternet.com/canadian-digital-social-mobile-statistics-global-scale-2014/.