Wealthy Canadians remain healthier than those with less — and Canada has made little progress in its pledge to close the gap, a national health group says.

The Canadian Institute for Health Information (CIHI) found poorer Canadians continue to smoke more, have higher rates of chronic bronchitis, and suffer more mental-health problems.

The methodology of the CIHI study was relatively simple: divide the respondents into five groups based on their income and measure 16 indicators over roughly ten years.

They included factors that influence health, such as rates of obesity and smoking, access to food and housing, rates of injury, and chronic disease.

“The magnitude of the inequality between the health of richer Canadians and poorer Canadians is significant across the majority of the indicators we reviewed,” vice-president of research and analysis Kathleen Morris said in a statement. “Over the past decade, inequalities did not change for 11 of the 16 indicators; in other words, the health of the poorest Canadians in relation to that of the richest is not getting better.”

The report, released in November, notes that in 2011 Canada pledged with other nations to implement the World Health Organization’s Rio Political Declaration on Social Determinants of Health, and in doing so, committed to reduce health inequalities in Canada.

According to CIHI’s report, the gap between rich and poor widened for three health indicators: smoking, hospitalization for chronic obstructive pulmonary disease among those under 75, and “self-rated” mental health.

For other indicators, such as diabetes, infant mortality, and obesity in woman, inequalities persisted but didn’t grow. For others, such as mental illness hospitalization, the gap between the rich and poor actually decreased.