What makes us sick is more than access to and quality of health care. The social determinants of health play a significant role. Today, the Canadian Medical Association released a report titled, Health Care in Canada: What Makes Us Sick?, based on its national dialogue gathered from a series of six public town halls across the nation on the social factors that cause poor health. The message from approximately one thousand Canadians was clear: poverty is the main issue and the biggest barrier to good health.
Along the same lines of the significance of income on health, the Wellesley Institute recently released a report, featured in a Toronto Star article, on the declining health outcomes of those who work but continue to live in poverty. Although the health of those who have sufficient income has remained fairly stable between 1996 and 2009, the health of those working and still living in poverty has deteriorated.
Other than income, the CMA reported on other key social determinants of health that participants identified at every consultation phase:
- Housing – where there are multiple effects on health of being homeless or being forced to live in unsafe and unsanitary conditions;
- Nutrition and food security – from getting enough nutritious food due to its unavailability and high cost, to the excess amounts of salt and sugar in processed foods; and
- Early childhood development – the combination of poor environment, poverty, and the lack of social support are “toxic stressors” that impair a child’s development, leading to adverse health impacts as the “brain cannot wait for funding.”
It isn’t hard to make the connections between the various factors that impact our health, which the CMA report did so as well. They provide twelve recommendations that aim to address the low health outcomes of Aboriginal peoples due to structural racism, and, the four key determinants mentioned above.
All of us can work toward making positive changes to some degree, but what is really needed is positive changes in policy and systemic changes at a governmental level. Participants of this study stressed that society, governments and health care providers all have a responsibility to address such problems as poverty, inadequate housing and nutrition.