The poorest men in Toronto are dying at a mortality rate that is a staggering 54% higher than the richest men in our city. Women are faring only slightly better – the difference in the mortality rate between poor women and rich women is 34%.
The mortality rate (a leading statistical indicator of premature death) is only one of more than two dozen health indicators set out in detail in a new report from Toronto Public Health called “The Unequal City: Income and Health Inequalities in Toronto, 2008”. The Toronto report comes on the heels of major research reports from the Canadian Public Health Officer and the World Health Organization that document the same trend on the national and the global scale.
Poverty is driving the health crisis set out in the Toronto report. Deep and persistent poverty in Canada’s richest city is leading directly to increased sickness and to early death. But it’s not just the poorest of the poor who are suffering (although they are paying the heaviest burden).
“The relationship between income and health in Toronto is not just about the extremes of wealth and poverty,” according to Toronto Public Health. “As the data in this report show, for most indicators there is a continuous gradient of health in relation to income – health status improves through each income increment. Toronto residents who live in high income areas are healthier than those living in middle income areas, and those who live in middle income areas are healthier than those living in low income areas. This means that health inequalities affect all Torontonians.”
“We cannot rate our collective health and well-being by looking only at those who are healthiest,” said Dr. David Butler-Jones, Canada’s Chief Public Health Officer, in the introduction to his “Report on the State of Public Health in Canada ” (June 18, 2008). “In short, health inequalities are fundamentally societal inequalities that we can overcome through public policy, and individual and collective action. Just as there is no sector of society that is untouched by health inequalities, there is no person or organization that cannot make a positive contribution to their resolution.”
“Social justice is a matter of life and death,” writes the World Health Organization’s Social Determinants of Health Commission in their report “Closing the Gap in a Generation ” (August 28, 2008). “Inequities in health, avoidable health inequalities, arise because of circumstances in which people grow, life, work and age, and the systems put in place to deal with illness. The conditions in which people live and die are, in turn, shaped by political, social and economic forces.”
Inevitably, there may be some who will say that poorer people are the authors of their own misfortune, arguing that they suffer an overwhelming weight of poor health and premature death because they choose to live unhealthy lives.
For those inclined to blame the poor for their poor health, consider these facts:
* there is a 40% increase in low-birth weight babies among the poorest Torontonians versus the richest. Toronto Public Health estimates that if poor and middle-income people enjoyed the same health as the richest people, then there would be about 1,300 fewer low-birth weight babies annually (that’s 1,300 newborns who would start their lives with an equal health advantage).