When parents bring a child into the clinic, they do so hoping for help to treat an acute illness or a longer-term problem. It might be something as simple as an ear infection, a chronic illness like asthma, or something more socially and psychologically complex such as ADHD. The expectation is that the child can take a prescription from their doctor or other health-care provider that will make a difference and improve their immediate and lifelong health.
The best prescription, however, may not be something for the child to take. The most effective way to improve a child's health may be to give their parents a raise.
Living in crowded, unsafe housing. The inability to afford a diabetic diet. Not filling a necessary prescription. Missing out on opportunities for early childhood learning and higher education. These and many other challenges related to poverty and low wages can result in poor health outcomes for kids now and into their adult lives.
As physicians, we see patients struggling with the resulting health problems in clinic, but we are not equipped to deal with the real problem -- poverty. The sources of the problem lie outside of health care; so do the solutions.
Income, education, employment, early childhood development, housing, food security: these "social determinants of health" are far more influential than health care on the quality and length of our lives. Chief among these is income, often referred to as the determinant of the determinants, given its direct influence on health and on factors such as where people can afford to live and how far they can go in school.
In June 2016, the government of Alberta announced its intention to increase the minimum wage in that province from its current $11.20/hour to an even $15 per hour by 2018. While Alberta has the lowest percentage of workers earning less than $15, it is still home to nearly 300,000 people employed at a rate far below what is necessary to afford the basic necessities of life.
The planned increase in the Alberta minimum wage to this level is a first in Canada, and has the potential to be one of the most significant public health interventions in the country this decade. The link between low wages and chronic illness has been well established, as has the connection with mental health issues such as anxiety and depression.
When it comes to child health, a report looking at U.S. birth data for the last 25 years showed an association between increases in minimum wage and birth weight -- an important indicator for future health -- along with increases in prenatal care and decreases in smoking. While not associated with wage increases per se, a study of the Manitoba Health Prenatal Benefit Program showed that giving low income expectant mothers an extra $81 a month resulted in significant decreases in low birth weight (21 percent) and preterm birth (17.5 percent).
Better income through a higher minimum wage means healthier workers and families.
Bringing minimum wage closer to a living wage is a simple way to help allow low income Albertans to live healthier lives by accessing better housing, more nutritious food and participating more fully in their community and the economy.
Aside from the health benefits, there are benefits to the economy as well. As the living wage movement has demonstrated, paying people enough to make ends meet leads to less costly employee turnover. It also means more reinvestment in local businesses, as those most marginalized in our communities are able to participate more in the economy and are more likely to spend their earnings locally.
The 2015 Poverty Costs report from Vibrant Communities estimated the cost of poverty to the Alberta economy at between 7.1 and 9.5 billion dollars a year. Much of this is through decreased economic activity, but a significant proportion is also due to increased health and social spending.
Difficult economic times have tightened provincial budgets. The promised increase to Alberta's minimum wage will go a long way to help bend the curve on growing health-care costs.
Alberta's leadership on increasing the minimum wage is a promising prescription for the health of its children. It's also a bold experiment in economic governance that other provinces would do well to watch closely -- and hopefully many will follow suit.
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