Tag Archives: public health

(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

(161) Tropical disease

This is alarming and awful: a New York Times Sunday Review piece about poverty and public health in the United States.  It seems lessons are imminent about the major relationship between tropical disease and poverty as found in warmer areas and among families living on as little as two dollars a day.  Low standards of living – and low expectations of assistance with the problems associated with such standards among certain ethnic groups – appears to be setting up a disaster featuring such things as cysticercosis and toxocariasis (worm infections), cutaneous leishmaniasis, murine typhus and Chagas disease.  Such a development is accompanied by cutbacks at the Center for Disease Control.

From the article by Peter J Hotez:

“They disproportionately affect Americans living in poverty, and especially minorities, including up to 2.8 million African-Americans with toxocariasis and 300,000 or more people, mostly Hispanic Americans, with Chagas disease. The neglected tropical diseases thrive in the poorer South’s warm climate, especially in areas where people live in dilapidated housing or can’t afford air-conditioning and sleep with the windows open to disease-transmitting insects. They thrive wherever there is poor street drainage, plumbing, sanitation and garbage collection, and in areas with neglected swimming pools.       

Most troubling of all, they can even increase the levels of poverty in these areas by slowing the growth and intellectual development of children and impeding productivity in the work force. They are the forgotten diseases of forgotten people, and Texas is emerging as an epicenter.”

Tropical Diseases: The New Plague of Poverty

(62) Poverty in Canada [Book review]

Today in Canada is Thanksgiving Day.  Jour de l’Action de grâce has been a national holiday since 1957.  What better spot on the calendar could we pick to review the second edition of Poverty In Canada: Implications for Health & Quality of Life by York University professor Dennis Raphael?

From first encounter this work comes across well.  The second edition clears 500 pages in trade paperback form and continues the fact-jammed academic dissection of poverty in the first edition, with extras.  Of course, there are tables and charts and analysis with references, index and suggestions for web resources and further reading all in the right places.  Plentiful ammunition for journalists, academics, policy makers and public servants to use against ignorance of poverty and hopefully poverty itself.  Students should find this book useful in many fields.

Poverty in Canada is too frequent, too consistent, too often racialized, too hard on too many children, too deep, too little studied, too (literally) sickening, too often not acknowledged at all, too often blamed on the individual affected by it, too closely linked to deliberately chosen neo-conservative economic policies, and too readily reduced or eliminated by quite reasonable efforts and means.  Again and again in this book Canada is seen to fare better than the United States but significantly worse than the Scandinavian countries when it comes to poverty.  Considering the size and economic output of this country our poverty has to be some of the craziest shit in the developed world.  If you are remotely interested in this topic you will find something of disturbing value in Raphael’s work.

Lived experience of poverty has been given more profile in the new edition.  This is sensible.  Elaborating the real thing is humane and complements the statistical approach.

Curiously, there is no specific mention of suburban poverty.  When we purchased Poverty In Canada we expected to find some direct mention of the phenomenon since the Brookings Institution has done a lot to make it a mainstream issue south of the border.  Additionally, we can claim to have directly observed suburban poverty in Canada through social service sector study and volunteering and through living in the suburbs.  In its own modest, amateur way this blog has begun to register and aggregate information about Canadian suburban poverty so we are surprised that a big gun academic like Raphael approaches it indirectly, hasn’t chosen to name it.  Some of this may have to do with the domestic statistical sources he uses and with the fact that the definitions of suburban and urban remains somewhat vague at times for many of us.

Ultimately, all poverty is a disaster and the labels attached to it are less important than the realities of it.  Nonetheless, the experience of poverty changes over time and suburbs are a new frontier of problematic social conditions in Canada.

Seriously, buy and read this book.  Mail a copy to your political representative.  Put it on your students’ reading lists if you are a teacher.  It’s available online and through most book stores.