Tag Archives: public health

(399) I’m hungry: can you loan me two grand? [BMJ Study]

Fruit & VegThe British Medical Journal looked at food costs and the diet/public health relationship in ten countries recently.  They confirmed that it costs individuals more to eat fresher, healthier foods but that not making better diets part of public health policy will have high social costs.  For a Canadian family the household budget requires an extra two thousand dollars a year to stay off a less healthy diet.  With over 1300 comments and several thousand “shares” in just a couple of days CBC online coverage of the report seems to have struck a note with Canadians.

Healthy eating adds $2K a year to family grocery bill. Lowering price of nutritious foods should be a public health goal, researchers say cbc.ca

See also: (355) Meal break with Jack Monroe

image: Van Tol Retail via Wikimedia Commons

(359) Your wages & your health [CMA & Metcalfe Foundation reports]

Flag_of_Canada_svgHey Canadians: income is everything.  The lower the wages the sicker the worker.  Within days of each other two reports have arrived backing up this statement.

What makes Canadians sick? Poverty, says a report from the Canadian Medical Association Ottawa Citizen
The CMA based its findings on six town-hall style meetings across Canada

Ontario’s working poor pay with their health: low-income workers got sicker than other adults as the economy faltered between 1996 and 2009
Toronto Star

(320) It’s the austerity, stupid

scissorsThe blogosphere has been abloom this cruel April with at least one sane, inspiring meme.  The new old new idea is that austerity doesn’t work and, in fact, is an utterly stupid policy for places with low growth, high unemployment, angry demonstrators, declining middle classes, broke governments, aging populations, unpopular wars, shaky currencies and discredited financial systems, which is to say pretty much everywhere.

You need only go to the instruments of the system itself in the United States alone to hear the catchphrase “austerity is stupid” ringing out. No less than the Federal Reserve (cue gurgling sound) or Foreign Affairs online edition (sit up straight when you are reading it, people) have said so with volume and clarity.

While austerity, the bashing of social budgets, defence spending, infrastructure spending, the letting go of civil servants and the privatization of state assets, has been mainly a European story to date, the English-speaking countries are now in the cross hairs.  The political actors and agents looking to knock down the public sector in those countries were in high school during the first great age of neoconservatism under Reagan, Thatcher and Mulroney.  Now it looks as if they hope to live up to their ideological parents and go them one better in the administration of noxious budgetary medicines and shock capitalism.  Hopefully the voters and taxpayers will wake up soon and resist austerity, not for ideological reasons, but because there is clear evidence it just doesn’t work, we can’t slash your way out of this mess.

Consider recent work from Canada’s Dennis Rafael at York University or an upcoming effort from Oxford & Stanford University researchers.  A decade of data headed into a new book from the latter is to be called The Body Economic: Why Austerity Kills which promises to further unveil the fact that austerity wrecks public health.  Suicide, infectious diseases, depression and tooth decay – you get more of this under austerity.

The path of austerity leads to sickness and death: new research shows government spending cuts have dire health effects. Welcome to malaria outbreaks and a rise in HIV infections.  MSN Money

Almost like cyanide-laced icing on a strychnine-and-bleach birthday cake, austerity was recently identified with arithmetic error and nasty questions of numbers-for-the-sake-of-ideology.  A key positional document of recent modern austerity economics has been found to have missing data and simply be wrong numerically!  A grad student discovered the error.

‘They Said at First That They Hadn’t Made a Spreadsheet Error, When They Had’
Chronicle of Higher Education

Who me? Austerity authors say don’t blame them: the Harvard scholars behind a prominent but error-riddled 2010 paper promoting fiscal discipline aren’t gaining sympathy with their defense.  MSN Money

The suburban poor in North America, and elsewhere, have been living with austere realities already. In these pages we’ve seen how the lack of social services, employment opportunities and transportation aggravates suburban poverty.  How about a counter attack on austerity and suburban poverty with stimulating projects to build better, healthier places and address these specific challenges?

The austerity delusion: why a bad idea won over the west
Mark Blyth at Foreign Affairs

This press release from the Federal Reserve, May 1st 2013 (did someone tell us irony was dead?) says “fiscal policy is restraining economic growth.”  All that Republican rage being poured into budgetary civil war is essentially wrecking recovery.  If the UK and Canada pick up cutback fever they will have the same problem.

Wasting a whole generation of people in Europe is stupid
Russia Times on Spain & Portugal 4:30

image: rusty tailor’s scissors via Wikimedia Commons

(317) Durham Region

OshawaThe Regional Municipality of Durham lies directly east of Toronto.  It’s almost a microcosm of Canada in that its 2500 square kilometers encompass serious suburbanization, some heavy industry, much commerical activity, farm land, rolling hills and areas where outdoor recreation including hunting and fishing is commonplace.  By and large the people of Durham Region are among some of the healthiest, best fed and most secure human beings in this unbalanced world.  Starting in the late 2000s, as the real estate/automobile industrial complex, so long the paymaster in Ontario, began to show signs of weirdness in terms of its future performance, a certain amount of poverty has come to be red flagged in Durham Region.

To take the understanding of suburban poverty beyond one-off profiles of people living in it requires detailed investigation and meaningful data attached to real experience.  That makes a recent document from the authorities in Durham of genuine interest.

The Price of Eating Well in Durham Region looks at one of the major impacts on family and personal well-being and concerns elucidated here can be found elsewhere.  The report looks at the cost of a simple, metaphoric basket of nutritious foods for a week for a family of four.  The cost of that metaphoric basket since 2009 has gone up by about $45.  Luckily, Durham appears to be a cheaper place to live than the rest of the province, for which there is also some comparative data.  Either way, about 8% of households in Durham experience food insecurity which generally means lowered quality and amount of food in those households.

Recipients of government support and low wages are under extra pressure in this respect.  More widely, the entire region is vulnerable to increases in energy prices, especially gasoline for personal motor vehicles (oversized, truck-style models are seen in abundance in Durham), and uncertainty exists over the future direction of real estate prices and the encroachment onto farm land of residential development.

The latter might seem a little ironic, the ongoing conversion of agricultural land into subdivisions and commercial property, in a place where food insecurity is now, pardon the pun, on the table.  Certainly, the laws for doing so are quite strict compared to past decades but perhaps real estate development has captured a little too much of the imagination in Durham, as in other places touching the Greater Toronto-Hamilton Area.  As with the country at large, Durham has too much child poverty and food bank use is a permanent feature of life for many, including people with jobs.

This particular report, and ones like it, merits attention and represents the detail needed to understand poverty.

The Price of Eating Well in Durham Region
7-page .pdf file

Poverty report raises red flags for Durham groups
Durhamregion.com

Social Planning Network of Ontario: CDC Durham
Links to a variety of reports 2007-2011

image: Two vistas from near Oshawa, one of Canada’s rock capitals and commercial centre of Durham Region via SeRVe61 & Rick Harris – Wikimedia Commons

(296) Minimum wage: medicine wage [Report]

Both_Cabinet_Respirator_in_WWIIAbout this time last year the Registered Nurses Association of Ontario published a report called Advocating for Vibrant Communities.  The document acted in part as briefing notes for submission to the provincial government representing the wisdom of nurses when it comes to social conditions and health.  The nurses called for an increase to the minimum wage in 2011 because they see a direct relationship between bad health and social difficulty.  The report helps to demolish arguments about the alleged immediate negative effects of increases to the minimum wage.  When it comes to health and poverty we can pay now or pay later.  Really, who is going to stand up and argue this one with nurses?

Advocating for vibrant communities 52-page .pdf file

image: AJ Faithful/Australian War Memorial via Wikimedia Commons

(279) Architect as doctor

heart diseaseVery powerful words about a grave bodily danger.  This article from Canadian Architect reiterates the now manifold warnings about the conseqeunces of sprawl, of poorly designed communities that discourage walking, connection to nature, that tend not to say anything memorable about why we are all here to begin with.  The evidence is well in that this critique embraces more than just personal taste.  $24 billion dollars a year is cited as the cost of preventable heart disease to the Canadian health care system.  How do you fight heart disease?  One way is with better design that makes for happier, fitter people more at home in their places and bodies.  This works for depression, childhood obesity and diabetes as well.  Architects, this one is aimed at you but we all should take heed.

Bringing healthy design to the suburbs

(263) Health & poverty downloads from Dennis Raphael

Poverty and inequality can wreck human health.  No debate there, really.  Without our health we are not fully the people we want to be, in our own life or the lives of those around us.  Dennis Raphael of York University has researched and written extensively about how Canada is, to be honest, in a state of underachievement in this area.  The second edition of his book Poverty In Canada: Implications for Health and Quality of Life was very well received at suburban-poverty.com in the fall of 2011.  We recently came across some further sources from Professor Raphael and pass them on via this posting.

Professor Raphael discussed Tackling Health Inequalities: Lessons From International Experiences online at Griffith’s University’s Podcasts for Social Workers earlier this month.  He was the editor of this work, released in the fall of 2012, and in it expresses concern Canada has become a laggard in preventing avoidable, unjust situations that degrade health outcomes.  Valuable stuff… Podsocs Episode 38 37:05

Data from Poverty in Canada and newer material has been made available online in .pdf format.  Professor Raphael is critical of mainstream media attention to these issues and he hopes to go directly to people with his findings.  Here’s the link:
Social Determinants of Health: The Canadian Facts

Along with co-author Juha Mikkonen, Raphael seeks to expose the general public and mass media to the overwhelming evidence that living conditions (housing, income, medical care, social supports and the like) trump individual lifestyle approaches (cutting down on cola consumption for example) in determining who will be healthy or not.  Social policy in turn, which is deliberately chosen in societies like Canada, has a massive influence on who stays healthy.  This runs contrary to the view that we as individuals are solely responsible for our health and had hence better get ourselves to the local gym, credit card in hand.  If we are low income Canadians, it would seem our health is at risk from our social class.  This is even more true for children.  Internationally, we see the social democratic countries of northern Europe spending more to protect their people from class-derived health damage – and reaping a social benefit for doing so.

See a lecture! The Politics of Population Health
York U material from Nursing 5190

Also, a presentation at the University of Toronto on how Canada stacks up against other nations in providing citizens with economic & social security.
Vital Discussions of Human Security vimeo.com 80:49
Series of talks at University of Toronto 2011-2012

See also: (62) Poverty in Canada [Book review]

(253) Have “eds & meds” peaked?

You’ve probably heard the term “eds & meds” by now.  The casual reference to what can amount to hundreds of millions of dollars worth of investment in community colleges, universities, hospitals, medical training and research facilities.  From the late 1980s this sector boomed in many communities in North America, very often in suburban aeas or in places simultaneously host to industrial decline.  The appearance of glassy new and upgraded facilities belonging to pharma companies, hospital non-profits, biotechnology firms and the like is usually considered an encouraging sign for the construction jobs and employment prospects associated with what can often be huge undertakings.  In a deindustrializing economy where the majority of employers are low wage service providers or retailers it is small wonder that a lot of faith has been put in this sector.  Buffalo, NY and Hamilton, ON are two examples of places where “eds & meds” are looked to by communities in transition.  Aaron Renn at newgeography.com sounds a cautionary note that the sector may be peaking.  Renn cites costs, especially the increasingly dismal economics of higher edcation as a personal investment in the United States as well as the decline in Gross Domestic Product and the declining growth rate of health care spending.  He feels the sector is simply maxed out and simply cannot continue to play the role it has been playing in urban and regional development strategies for the last couple of decades.

The end of the road for eds and meds

image: NYPL Digital Gallery via Wikimedia Commons

(163) Inequality and health in England [King’s Fund report]

Crossing the pond to the United Kingdom from Canada we find at least  two things much the same.  The first is a public health care system.  The second is that despite the latter the richer the person the more likely they are to be in good health and live longer.  At least, that is the finding of a think tank called the King’s Fund.  They have taken a longer term look at diet, smoking, exercise, and drinking.  Not exactly a pretty picture, the influence of these things on the cost and provision of health care.

Class divide in health widens says think tank Guardian

Clustering of unhealthy behaviours over time: implications for policy and practice King’s Fund site

(162) Inequality and health in Canada [CMA report]

This post introuduces the Progressive Economic Forum to suburban-poverty.com’s readers with an item confirming the relationship between income levels and health in Canada.  PEF cites a new Canadian Medical Association report.  It seems that Canadians remain fortunate people in terms of health and wellness but a gap has opened up based on income.  If you are poorer you die sooner and have more problems over the years.  The author of this piece supports the view that beating up on the poor for bad lifestyle choices is too often used as an easy out for explaining the social determinants of health.  An item on the same CMA report on the CBC website got just over 800 comments in a short time.  Clearly this is an important issue, one Canadians know to feel strongly about.

To address health inequalities, look beyond the role of individual responsibility PEF

‘Wealth equals health,’ Canadian doctors say: lower-income groups report poorer health CBC.ca

CMA poll finds “worrisome” gap in income-related health status CMA.ca