Physician, St. Micheal’s Hospital | Assistant Professor, Family Medicine, University of Toronto
Danyaal is a physician with the Department of Family & Community Medicine of St. Michael’s Hospital, and an Assistant Professor of Family Medicine at the University of Toronto. His writing, research and teaching focuses on the social determinants of health in both health policy and the delivery of health care. Additional writing can be found at danyaalraza.ca.
Climate change is a complex problem, one that touches on so many parts of our lives. It links greenhouse gases with extreme heat, worsens medical conditions like asthma and COPD, and demands we change our approach to transportation and power generation.
The evidence is clear. Social factors, like housing, income and wealth, educational background, and race are more powerful determinants of health outcomes than our behaviours, genes, or even the healthcare system itself.
With the exception of Prince Edward Island, no province or territory guarantees a minimum number of paid sick days for employees. Across the country, young people, seniors and low-wage workers are the hardest hit. Less than half of young and older employees work in jobs that provide paid sick days. The lower an employee's pay, the less likely they are to be covered by a voluntary sick days policy. This needs to change.
Unlike any comparable country, Canada's universal public health care system effectively ends as soon as a patient is handed a prescription to fill. Millions of Canadians have no drug coverage at all and millions more have coverage that is inadequate to ensure access to medicines.
Beyond Quebec, despite the endorsement of the public health and policy community, a Health in All Policies approach has not found the political will necessary for meaningful change. But the past year offers signs of hope, with governments in Canada from across the political spectrum beginning to see the potential.
The gap between rich and poor in Canada is growing. What is indisputable to those of us working in the health care sector is its effect on health of Canadians. Health is a concern common to all, regardless of political affiliation, and does not exist in isolation from this growing problem. Evidence continues to mount that rising income inequality is contributing to the deterioration of the health of all people in Canada, regardless of their income level. As a family doctor who sees the impacts of public policies on the front lines, I find myself nodding in agreement to calls to action. The time for leadership on this issue has come.
The report of the Ontario Social Assistance Review Commission, released October 24, offered some important steps toward health-focused change. Its release was set to spark a badly needed discussion on reform of a broken and anemic system. The surprise resignation of Premier Dalton McGuinty changed that -- this debate has been conspicuously absent.