Findings informed by town hall events, including one in St. John’s
The Canadian Medical Association (CMA) has compiled a list of recommendations to address social determinants of health, informed by several town hall events held this year across Canada, including one in St. John’s.
Titled “Health care in Canada: What Makes Us Sick?,” the 14-page report places poverty, housing, food security, and early childhood development as priority determinants requiring action. It said those issues were raised in every phase of CMA’s consultation process, which also involved an online component.
“I think it’s bang on,” said Kimberly Dawson Yetman of the report’s recommendations. She is the executive director of the Newfoundland and Labrador Housing and Homelessness Network (NLHHN) and co-hosted the CMA town hall in St. John’s on June 3.
An action plan to eliminate poverty involving all levels of government is the first recommendation listed in the report.
A CMA public survey from 2012 found that among respondents who earned less than $30,000, only 40 per cent said they were in good or excellent health. By comparison, 70 per cent of those who earned more than $60,000 said the same.
Yetman said getting governments to work together on poverty has been a part of NLHHN’s key messaging since it was founded.
“We know that housing and poverty are complex issues, and you need all levels of government working together,” she said, going on to make note of the provincial government’s investment in its strategy on poverty. According to the Department of Advanced Education and Skills, there are 80 ongoing initiatives that are a part of that strategy.
The report also recommends that the federal government fund a pilot project to test the viability of a guaranteed annual income as a mechanism to combat poverty.
On housing, the report recommends that government develop strategies to make affordable housing options more readily available to low- and middle-income earners. It also suggests there is a need for more housing options for people with chronic mental health conditions leading to homelessness.
The St. John’s panel highlighted the fact that prosperity in Newfoundland and Labrador “has exacerbated the housing problem” through increased prices and a depleted stock.
The report addressed the need to ensure access to nutritious food regardless of geographic location and income by advocating for a national food security program.
Yetman said the cost of food, much like most other items, is rising, but most incomes have not been rising at a rate comparable to inflation.
The St. John’s town hall made note of the province’s cultural influence on food consumption, as many residents consume salty and deep-fried foods on a regular basis. They also noted that soft drinks represent a cheaper alternative to nutritious beverages such as milk and juice.
Mention was also made of vegetable gardens becoming less common in rural parts of Newfoundland and Labrador.
On early childhood development, the need for investment in education programs and parental supports was emphasized in one recommendation.
One panellist in St. John’s mentioned a program giving children and their parents the opportunity to participate in a community garden, calling it a fabulous opportunity.
Other items covered in the report’s recommendations included a call to create local databases of community services and programs for health professionals to consult, further investment and a comprehensive strategy to improve the health of aboriginal people, educational efforts to raise awareness across the country about aboriginal health issues and the need for Ottawa to consider the health effect of decisions made by cabinet.
Aside from taking the recommendations at face value, Yetman suggests those in power need to consider the cost-saving implications of implementing such initiatives.
“I don’t think that’s often something we often talk about, because when we think of health care, we think of the hospital system, the doctors, the nurses. We don’t think about these other social determinants of health, which could really bring huge cost savings for the government if we could get at the root cause of these issues.”
Yetman said NLHHN plans to take these recommendations and use them to create a dialogue with government partners.