In 1976 Canada became a State Party to the International Covenant on Economic, Social and Cultural Rights, an international document that recognizes “the right of everyone to the highest attainable standard of physical and mental health.” Since then, Canada has also signed and ratified numerous other international treaties that recognize the right to health and make it a legally binding obligation within its jurisdiction.
So, do we have a right to health in Canada? Yes.
But what does that mean?
The right to health is not the right to be healthy. There is no policy or health care service that can prevent all injuries or illnesses. Instead, the right to heath is about ensuring that people have equal, open access to opportunities for good health.
To do this, there are two main parts to the right to health. The first is relatively straightforward. The Canadian government must ensure that our health care systems are available, accessible, adequate, and of good quality to eliminate barriers for all people in Canada, not just a privileged few. But the right to health is not just the right to health care. Governments must go further to address the underlying determinants of health, which are much more complex than addressing health care. The defining document on the right to health specifies that the underlying determinants of health include food and nutrition, housing, access to safe and potable water and adequate sanitation, safe and healthy working conditions, and a healthy environment. This means that governments must take deliberate action in each of these areas to ensure that people’s needs are met to enable them to achieve good health.
Failure to uphold the right to health can lead to health inequities: differences or disparities in health outcomes that are avoidable, unfair and systemic. The result is that certain groups in our society have poorer health outcomes due to social characteristics beyond their control, for example race, socio-economic status, gender and so on.
Part of the problem with discussions around health in Canada is our framing of the issue. Health is often discussed as if it is a privileged good that is provided in doctors’ offices and hospitals or as generous services from the government instead of entitlements owed to rights holders. Extra spending on health care services and the determinants of health is seen as a “nice-to-have” offered in times of prosperity and cut back when money is limited. The problem with this way of thinking is the significant barriers to good health it poses for specific groups. For example, almost one in ten Canadians do not have equitable access to prescription drugs due to high drug costs and lack of coverage, while inadequate action on food security means that the number of families using food banks annually is rising in Ontario.
So how can we ensure that the right to health is protected and upheld in Canada?
First, we need to frame health differently. Instead of asking the government to spare an extra dollar to ensure that vulnerable groups have better access to services, we can use stronger, clearer language, with legal implications, to demand sound and fair policies that impact good health. As well, we can no longer afford to only think about health care; greater action on other determinants of health is required. This means talking about social issues, like poverty, as underlying determinants of health that demand government action to uphold people’s rights. And when there are clear violations of the right to health, we can use the courts to overturn government decisions or health programs, which has been successful in a number of cases.
To really make progress, we need to get people talking about health as a right. Some people already are, but we need to increase the number in order to amplify the voices and strengthen conversations.
On February 4, the Wellesley Institute is co-hosting an event with MASS LBP and Upstream that will explore new approaches to connecting politics and health. Along with three of Canada’s leading activist physicians, we ask: Do Canadians have a right to good health? Please join us in what will be a great conversation and call to action. Register today.