In a two-minute clip of the CBC’s The Current podcast on health and wealth, a refugee claimant living in Toronto talks about how immigration, homelessness and poverty have all negatively impacted his physical and mental health.
Our health is much more than visits to the doctor and filling prescriptions. Multiple socio-economic factors affect our health even before we step foot into a doctor’s office. In the podcast, Drs. Gary Bloch and Julia Morinis, identify poverty as the biggest determinant of health. Using an easy to understand example, Dr. Morinis describes how she incorrectly prescribed ointment for a baby’s diaper rash when the correct treatment was actually diapers for a family that could not afford them.
The relationship between poverty and low income is well established. One of the ways poverty affects our health is by limiting choices. For instance, if a person with diabetes is given a dietary plan by a health care provider but relies on food banks to survive, their chances of adhering to such a plan are slim. Growing up in poverty can also limit children’s opportunities for good health. Early childhood development is key for long-term health, however many low-income families cannot afford daycare or adequate housing to ensure good development.
Poverty also affects peoples’ access to health care services. There are multiple barriers to care for low-income households, ranging from discriminatory practices and sometimes attitudes of health professionals to not being able to afford bus fare for a visit. Additionally, many low-income households lack insurance for health services such as dental, vision and prescription drugs. While such barriers to adequate health care remain, people in poverty will have worse health outcomes than those who are better off.
If poverty is a health problem then what is the solution? Ultimately the answer lies with policies that address and eliminate poverty. By tackling poverty through coordinated initiatives such as Ontario’s Poverty Reduction Strategy, the negative impacts of low-income on health can be reduced and, eventually, eliminated.
On the front line, Dr. Bloch suggests actions for health care providers to minimize the negative health effects of poverty. He proposes that they listen to patients to understand not only the physical aspects of their health but the social ones as well. Health care providers have a bigger role to play besides prescribing medication, including assisting patients to navigate a complex system and access income support resources.
Poverty is a disease that requires immediate action. We know the problem and have named it, now it is time for every level of government to step up, work together and treat it.
Vanessa Abban is a research assistant at the Wellesley Institute.