Following hard on the heels of global, national and local research reports that confirm a deep and persistent health crisis, the Conference Board of Canada (an independent, national research organization) has released a health report card that ranks Canada as tenth among 17 major countries. “Increasing levels of mortality due to diabetes should be ringing alarm bells, not only among Canadian policy makers but also among the public,” says the Conference Board report. “Given the increasing prevalence of chronic diseases, Canada must adopt a new business model for health care that focuses on both preventing and managing chronic disease.
But the Conference Board analysis fails to move beyond averages as it assesses ten health indicators. Yet, averages mask the terrible reality that virtually every health outcome is worse for lower-income people than for upper-income. The Conference Board has missed this important health reality – and that leads them to propose a policy solution that also misses the mark.
The Conference Board concludes that “lifestyle choices are integral to determining the degree to which a population may suffer from chronic disease” when, in fact, deeper research demonstrates that socio-economic factors (especially income – which allows people to purchase nutritious food and healthy housing, to name just two key determinants of health) are the most important in determining health.
The Conference Board recommends “increased vegetable and fruit consumption”. This is good advice, to be sure, but lecturing the 720,000 Canadians who are forced to line-up at food banks every month because they don’t have enough money to buy nutritious food about eating their veggies is off the mark.
The Organization for Economic Co-operation and Development’s latest survey of poverty and income inequality among the richest countries of the world (October 2008) was particularly harsh in its assessment of Canada’s record over the past decade. Among the findings, poverty is up in Canada, growing income inequality here is the second-worst among OECD countries, and Canadians living in “are likely to remain poor for longer than in most countries”.
So, while “lifestyle” factors can make a difference, the biggest factors are socio-economic.
For more information, see Toronto Public Health’s “Unequal City” report (October 2008); the Canadian Public Health Officer’s “Report on the State of Public Health in Canada” (June 2008); and the World Health Organization’s “Closing the Gap in a Generation” (August 2008).