- While a misleading "wealth equals health" headline seems to have been the main take-away from the CMA's health polling, Iglika Ivanova frames the issue more accurately in pointing out that the non-wealth determinants of health are the areas where Canada has far more room for improvement:
(L)ifestyle choices are a relatively small factor in shaping health outcomes, much less important than our living and working conditions. In fact, living and working conditions often constrain our choices to a very large extent. The health research is very clear (p. ix):
In other words, the income-related health inequalities the CMA report documents represent unfair and avoidable ill health, and it causes enormous human suffering, costs years of the life of our fellow citizens. As one of the Canadian members of the World Health Organization Commission on Social Determinants of Health, Monique Bégin points out:“Chronic disease can no longer be explained only as an outcome based on engaging in the ‘wrong’ health behaviours. There is a need to look beyond individual responsibility to understand the ways in which the social environment shapes the decisions we make and the behaviours we engage in.”
The truth is that Canada – the ninth richest country in the world – is so wealthy that it manages to mask the reality of poverty, social exclusion and discrimination, the erosion of employment quality, its adverse mental health outcomes, and youth suicides. While one of the world’s biggest spenders in health care, we have one of the worst records in providing an effective social safety net. What good does it do to treat people’s illnesses, to then send them back to the conditions that made them sick?
This is a national embarrassment and we all have a responsibility to ensure that every Canadian has the opportunity to lead a healthy life.- And fortunately, the CMA's new president recognizes the distinction:
“We need equitable distribution of health care resources and services so that – within reasonable restrictions such as geography and population [density] – everyone has equal access to important health-care services,” Dr. Reid said.- Carol Goar reviews Joseph Stiglitz' The Price of Inequality, including this optimistic set of future outcomes:
Beyond pushing for universal access to essential medical care, she said she will use the CMA presidency to raise awareness about the role of the socio-economic determinants of health, and the need to focus on marginalized groups like aboriginal people, those with mental illness and the isolated elderly.
“That’s a huge passion of mine,” she said. “I see the impact of social determinants every day in my work.”
Looking ahead, the economist sees two possible scenarios.- But then, some people are going out of their way to avoid noticing the corrosive effects of inequality - with Benjamin Hale coining the phrase "veil of opulence" to describe the mindset shared by the Republicans south of the border (among other right-wing parties around the world).
One is that the mega-rich 1 per cent of the population will realize it is in their own interest to reverse today’s extreme polarization of income. No one benefits from a less productive, less dynamic and less efficient economy.
The other is that the 99 per cent will realize they’ve been sold a bill of goods by their leaders and demand change in ways governments, political parties and employers cannot brush off.
People intuitively get it, he says. They just have to muster the political will to act.
- Finally, Adam Kovac wonders whether we'll see a provincial NDP develop in Quebec. And I'd have to see the prospect as far more likely now than at the start of the current election campaign, as Quebec Solidaire's gleefully hard line on sovereignty strikes me as likely to severely limit the growth potential for the main party which would otherwise have a chance to fill a left-wing vacuum.