Life and Death by Neighborhood

I came across an article in Maclean’s this past weekend which focused on Canadian healthcare, and how where you live may influence when you die. As I read further into the article,  investigative reporter Steve Buist collaborated with Neil Johnston, an epidemiologist and faculty member in McMaster University’s department of medicine, and found:

The social determinants of health—income, housing, education, employment, early childhood development and race—divide us as certainly as any caste system. Where you sit on the income gradient sets your life course, determining how well you live and how soon you die. Death comes years earlier with each step down the income ladder.

Now this really should not surprise any of us. Economics and class does influence lifestyle along with access to healthcare, even in a country that has socialized medicine. In the Canadian healthcare system it is the basics that are covered , but  decisions on what extras will be offered continue to be determined by the province, unless one has private supplemental insurance. In order to have supplemental insurance, one needs the financial means to purchase it, thus giving credence to Buist and Johnston’s findings.

The article focuses on Hamilton, Ontario and Sudbury, Ontario, but this could be any city or town in Canada. Those with the financial means have access to better healthcare, live in better neighborhoods and have access to healthier food options. They tend to be more educated, to have more options available re: what neighborhood to live in, options for private vs. public schools, better job opportunities, and are more likely take advantage of yearly check-ups.

Focusing on non-medical social problems is a priority for the Canadian Medical Association (CMA), which advocates for a sustainable, equitable and more effective health care system. Health is more affected by socio-economic factors than by doctors, drugs and hospitals, CMA president Anna Reid, an emergency room doctor in Yellowknife, said in an interview. “We feel we have a responsibility—a duty, actually—to start advocating for policies that change people’s life circumstances.”

Studies find the problem is a lack of accountability and inadequate budgeting for such necessities as housing, education, social services, child care, policing and other non-health determinants, which rest with different levels of government, each responsible for one puzzle piece that rarely fits into a complete picture. Experts say it’s a jurisdictional nightmare and an excuse for inaction.

So, how to make this change happen? What can each and every resident or citizen do? Write to the necessary provincial and federal government officials and advocate for prevention! Healthcare is a fundamental human right, everyone, no matter what their financial means, should have access to the same levels of healthcare and social services.

On March 6th, Maclean and the Canadian Medical Association will host a town hall style discussion in Hamilton, Ontario at the McIntyre Performing Arts Centre. The conversation about the health effects of disparities in income, education, housing and employment will continue in the coming months in the magazine and at town halls in Charlottetown and Calgary, other provinces in Canada. 

These kind of discussions should be happening world wide between invested and interested parties. My hope is to either read or hear about more town hall style discussions in the coming years.

Written by Victoria Brewster, MSW
SJS Staff Writer in Canada