This year’s proposed federal budget takes some important steps forward on issues that are crucial to population health and health equity. In particular, we acknowledge that the government proposes to increase its investments in affordable housing and ending homelessness and is introducing funding for the Canada Disability Benefit, which will provide assistance to low-income persons living with a disability. Their decision to fund some of these changes through increased taxes on high income and wealthy individuals and corporations is admirable, and Wellesley Institute supports this and future action that should be targeted at reducing income and wealth inequality.
We also acknowledge the government’s proposals to explore automatic filing and to automatically enroll every child in the Canada Learning Bond program as positive steps towards recognizing that programs requiring applications disproportionately leave out structurally disadvantaged groups. The proposal to increase funding for school food programs will also help some children have enough to eat.
However, there remains much more to be done to promote health and deliver health equity, including ensuring everyone in Canada has the resources they need to thrive – to live a healthy, meaningful life. There is significant evidence demonstrating how important thriving and health equity are, and we hope future budgets will take this much more seriously.
Wellesley Institute’s recommendations for this year’s federal budget called for action in four areas we believe are acute and crucial to Canada’s future:
- Create and implement of a national health equity plan.
- Establish an acceptable level of resources that ensures everyone in Canada has what they need to thrive – to live a healthy, meaningful life.
- Take federal action to house at least one-third of the chronically homeless population within 10 years, along with information on how they will hold other levels of government accountable for the rest.
- Directly fund municipalities to develop and implement sustainable, collective and multi-sectoral mental health and well-being strategies, along with a new social contract for mental health.
National Health Equity Plan
There are significant health inequities between different groups in Canada. These were and are being exacerbated by the COVID-19 pandemic and ongoing international affordability crisis. Life expectancy has decreased, and it is very likely structurally disadvantaged persons, families and communities are most impacted. If we want to build back better, we need to build back fairer – achieving our potential both socially and economically requires a healthy population. Together, this means we need a health strategy and a health equity strategy.
Leadership from the federal government on equity and ensuring that health transfer money is linked to equity is vital for Canada.
This budget does not propose a national health equity plan, and we urge the government to begin the work now to put one in place.
Thriving
This budget proposes a new Canada Disability Benefit at a maximum of $2,400 per year, and estimates this will help more than 600,000 individuals. We are concerned that benefit maximum is not adequate. It is unclear what evidence was relied upon in selecting this amount, but it is not the amount a person with a disability needs to live a healthy life. Most people who have a disability live below the poverty line. Few are currently at a living wage and very few would meet criteria for having enough resources to thrive.
Wellesley Institute has called for clear vision, targets and methods from governments to address health inequities. We are pleased to see the budget outlines a goal that the combined federal and provincial supports for persons living with disabilities should grow to the level of support provided to older adults through Old Age Security and the Guaranteed Income Supplement. Wellesley Institute supports the government’s willingness to establish a target, but we urge the government to increase that target to a level adequate to support thriving in persons living with disabilities.
Homelessness
We acknowledge the government’s commitment to funding or increasing funding for the Affordable Housing Fund, Canada Rental Protection Fund, and Reaching Home. Wellesley Institute continues to recommend increasing the number of affordable units, and ensuring these units are not lost.
Wellesley Institute focuses on ending chronic homelessness within 10 years as a crucial first step towards ensuring everyone in Canada has a home that is affordable, adequate and healthy. Homelessness is devastating to health and health equity.
Unfortunately, although these proposed investments will help, they are not paired with projections of how many people will be helped by these programs, and particularly, how many people will be lifted out of or prevented from falling into chronic homelessness. We urge the government to provide those estimates to the public as soon as possible and to include them in a 10-year plan to end chronic homelessness everywhere in Canada.
We also acknowledge the proposal for additional funding to address encampments and unsheltered homelessness. Specifically, we are pleased this funding will be available for supportive housing units – a crucial part of ending chronic homelessness which Wellesley Institute, the Canadian Mental Health Association Toronto and the Toronto Alliance to End Homelessness called for in the Toronto Supportive Housing Growth Plan. However, this funding also lacks projections and targets to ensure everyone in these situations has access to an affordable, adequate, healthy home, and this amount of funding will not meet even the capital costs for this year’s supportive housing needs.
The government needs to put in place clear, public, equitable targets for ending homelessness and for how many people each federal program is expected to help. It then needs to ensure those targets are met to meet at least it’s one-third share of reducing homelessness within 10 years. This should include an assessment of the need for other jurisdictions to meet their obligations.
Mental Health
We acknowledge the government’s proposal to create and fund a Youth Mental Health Fund as well as an Emergency Treatment Fund to provide healthcare to substance users. We urge the government to establish a social contract for a mentally healthy Canada, involving all levels of government, business and the non-profit sector to develop a plan with clear targets that would ensure mental health is improved, and improved equitably across Canada.
This budget does not fund municipal well-being initiatives, and we urge the government to include sustainable funding in Budget 2025.
Conclusion
There are tangible steps in Budget 2024 that will improve health and health equity across Canada. Unfortunately, many gaps remain. The government has not provided plans with clear targets to achieve health equity, end poverty, end homelessness, or improve mental health and well-being. Plans with visions and targets – not just methods like programs and spending – are essential for accountability and progress on these crucial issues. Perhaps most importantly, they would give everyone in Canada a vision of a better future we could all believe in.