While the incomes of Canada's wealthiest are increasing, the absolute wealth of our poorest is decreasing. As this gap grows, so too do the differences in people's health risks, care and outcome. The poorer people are in Ontario, the more likely they are to have shorter lifespans, to be overdue for screening tests and to suffer from multiple chronic health conditions.
In his letter to the minister, Prime Minister Trudeau tasked Health Minister Philpott with "engaging provinces and territories in the development of a new, multi-year Health Accord with long-term funding agreement." As the health ministers meet in Vancouver, how can they bend the curve toward a less costly and more effective health care system? How can they ensure the funds invested this time around will buy real improvements in health?
An interview with Clive Weighill - Saskatoon Police Chief and President of the Canadian Association of Chiefs of Police: Some politicians talk about getting tough on crime. I'm saying you don't just want to get tough on crime, you have to get tough on the issues of poverty, poor housing, disadvantage. People are products of their environment, and if we can't solve those social issues, we're not going to solve the big picture in the end. I firmly believe that we have to work on poverty.
As a medical student, I learn plenty about complex management of disease once it's started -- but rarely do we learn about what keeps people well in the first place. Aaron Antonovsky was a medical sociologist with a similar curiosity. Based on three components, his research provides a valuable framework for how we should approach public policy making in the area of health and wellness in Canada.
Food insecurity, also known as 'food poverty,' can cause significant anxiety over diminishing household food supplies and result in individuals modifying their eating patterns -- adults skipping meals so children can eat or sacrificing quality food choices for cheaper, less healthy options, for example.
income splitting primarily benefits middle- and upper-income families, provides relatively little tax relief for low-income families and skirts single parents altogether. Just as importantly, it acts to deter both parents from equal engagement in the workforce and devalues family policies that promote dual engagement.
What good is it to treat illness if we can only send our patients back to the conditions that helped make them sick to begin with? Our health is strongly influenced by factors such as income, our working environment and affordable housing, over which neither patients nor medical doctors have much control.
My patient reminded me that day of something that I have always known -- access to housing is not just a matter of rights and justice, it's also a matter of health. When his mental health deteriorates, he can indeed access the hospital care he needs, but if providing him access to housing can help keep him healthier, costs us less, and is the right thing to do, then why not do it for everyone? This federal election, when we vote, we must vote for housing for all, and no matter who is elected, we must call on them to take action immediately.
A Commissioner for Children and Young Persons could report on the status of children. They would ensure all sectors consider children in decision-making. A Commissioner for Children and Young Persons could also provide a framework of accountability for a federal commitment to eliminate child poverty.
Despite a strong economy, Saskatchewan has a deficit in access to safe and affordable housing. The Saskatoon Housing Initiatives Partnership performed a "point-in-time" count of people without a home on a given night and found 405 people. The number from these counts has steadily increased. What's especially disturbing is that 45 of the homeless individuals in this year's count were children. Across Canada, an estimated 235,000 people will experience homelessness in the course of a year, with 35,000 homeless on any given night. Beyond those who are homeless, many Canadians struggle to maintain the housing they have.
The success of Airbnb and Uber -- two of the largest sharing economy platforms -- stems from their ability to offer lower prices for consumers, lower barriers to entry for service providers, work flexibility, and ease of connecting with renters/users. But what's behind the bargains seems to be posing potential health risks for service providers and service users alike. The sharing economy is not generating what would be considered to be "good" jobs.
It surprises most people to know that about one in 200 Canadians is detained or incarcerated in jail or prison every year, and that the average length of stay in these facilities is only a few weeks. Time spent in jail or prison can serve as an opportunity to improve health. But achieving this goal will require a change in attitudes about health care in custody and reforming health care in correctional facilities.
Recently, I was fortunate to attend the Global Symposium on the Role of Physicians and National Medical Associations in Addressing Health Equity and the Social Determinants of Health held in London, England. I sat down with Dr. Simpson to explore the stories, the evidence and the politics that come into play when doctors are actors for social change.
Saskatchewan is among a number of regions in Canada, such as Manitoba and even our nation's capital, currently experiencing alarming spikes in the spread of HIV. B.C. has an impressive track record for slowing the spread of HIV/AIDs in the province. The B.C. Centre created a Treatment as Prevention strategy which provides widespread access to HIV testing, care, support and treatment. Keys to the strategy's success have been political commitment, programmatic focus, ongoing innovation coupled with monitoring and evaluation, appropriate resourcing and free services (including fully free antiretroviral therapy (ART)).
There has been a dramatic increase in the number of Canadians living with obesity over the past few decades and it is often cited as a risk factor for other chronic health conditions including type 2 diabetes, hypertension, cardiovascular disease and some forms of cancer. This means that obesity is frequently a hot topic in the news. But media stories often miss the mark when it comes to informing Canadians about the complex factors that lead to obesity.
Last fall when I visited Canada, I met a Toronto doctor named Gary Bloch who has developed a poverty tool for medical practitioners. Bloch's idea was to zoom in on the social determinants of health -- food, housing, transportation -- all poverty markers linked to bad health and poor health outcomes.
The evidence for the link between factors determined by social policy and health outcomes is crystal clear. Decades of studies have demonstrated that income and its distribution, education, employment, housing, food security and the wider environment have far greater impact than health care in influencing our health.
This isn't just an American problem. Hundreds of thousands of Canadian children are growing up without enough. Low-income children, especially minorities and aboriginals, are growing up at an increased risk of preventable diseases -- diseases both classically medical and mental health related that arise as a result of their early living conditions and will affect us all. These numbers don't simply represent difficult childhoods; they mark a huge group of Canadians who are growing up without the supportive environments they need to develop into healthy adults.