For those interested in media coverage of social
determinants of health, here is a copy of a letter to the
editor published in today's National Post, which was partly
inspired by my participation in the Social Determinants of
Health Conference at York Univesity last weekend.

I agree we need to do all we can to put social determinants
of health on that national political landscape and one
way is to regularly relate current events and issues to a
broader population health agenda.

Michael

**
NATIONAL POST

Tuesday, December 10, 2002

Kyoto's health benefit

Dennis Modry brings attention to important issues by suggesting
that the costs of implementing the Kyoto Protocol may have social
and economic implications that will, in turn, affect the
health of Canadians (Kyoto's Health Hazard, Dec. 7).
   The human health impacts of climate change have,
unfortunately, been largely left out of public discussion.
And we do, too often, forget that health status has more to
do with prevailing social, economic and environmental
conditions than with access to health care.
   But readers deserve a fuller examination of the links
between climate change and health than Dr. Modry's
decidedly one-sided offering, which ignores the health
impacts of not ratifying Kyoto.
   The health consequences of not taking this first
international step toward reducing carbon emissions may be
significant. Papers by the Canadian Public Health
Association and the Canadian Association of Physicians for
the Environment project that direct and indirect human
health impacts of continued growth in greenhouse gas
emissions include heat stress, injury and illness from
extreme weather events and the expansion of insect-borne,
water-borne and respiratory diseases. Contrary to Dr.
Modry's claims, these reports suggest that violence and
conflict due to social and economic disruption may be more
likely to result from inaction, rather than action, on
climate change.
   Dr. Modry is right that economic resources are needed to
create the social and economic conditions that form the
basis for population health. But surely the efforts of
health professionals would be better spent promoting
policies conducive to health (income equity and security,
adequate housing, affordable child care, safe and
supportive workplaces) than trying to put off societal
action for a sustainable environment, which forms the basis
for the future health of all Canadians.

Michael Polanyi, assistant professor, University of Regina,
Regina.

**

[Here is the letter to which I responded:

NATIONAL POST

Saturday, December 07, 2002

Kyoto's health hazard

Given that socioeconomic circircircumstances directly
correlate with health and well being, a reduction of an
individual's or a family's socioeconomic status will
inevitably lead to more illness and a reduced quality and
quantity of life. Kyoto, unfortunately, has the unhappy
potential to reduce the standard of living of all
Canadians. Those who become unemployed or are forced into
lower paid employment, along with their families, are at
greatest risk. Health care expenditures can only go up as a
consequence of Kyoto, further adding to our economic
burden. Where will the additional money for health care
come from?
   Secondly, some individuals who become impoverished,
sadly, may turn to crime as a means to improve their
lifestyle, albeit at the expense of the reduction of the
lifestyle of the victims of crime, consequences which may
include both personal injury and even death. Most
certainly, an increase in crime will increase the cost of
fighting crime. If Kyoto is implemented, where will the
money come from to deal with the health risk to the victims
of crime and how will we finance the additional cost of
fighting crime?
   Thirdly, better educated individuals make better health
choices. If billions are spent on Kyoto, how will we be
able to support our educators, health care providers, our
education and health care systems and pay for the public
policy necessary to assist individuals in leading healthier
lives?
   Fourthly, a bullet in the head or being blown to bits by
a bomb is a bad health outcome, most would agree! Where
will the money come from to protect Canadians from
terrorists, if billions of dollars (to purchase carbon
credits) are channelled to third world countries run by
dictators who foment terrorism, or if billions are lost
simply due to a reduction in economic activity? Already
over $16-billion of investment in Alberta is on hold
consequent to the Kyoto chill.
   Those who would advocate the passage and implementation
of Kyoto most likely have the best interest of the
environment and our future health, and the health of our
children, at heart. However, not every one who supports
Kyoto does so for truly altruistic reasons. Nevertheless,
it is clear that the debate on the passage and/or
implementation of Kyoto is incomplete. No responsible
government would ever pass a program that would knowingly
compromise the health of its citizens now or in the future.
Although the rationale for Kyoto is unproven, or at least
not universally accepted by scientific undertaking, there
is no question that Kyoto will burden Canadians
economically. The aforementioned potential health
ramifications consequent to Kyoto -- and likely there will
be others -- should be of concern to all of us. Our health
and well being are truly at risk. Accordingly, in dealing
with climate change, Canadians must come together with a
made in Canada solution that does not at all jeopardize our
socioeconomic well being collectively, or individually.

Dennis L. Modry, M.D., clinical associate professor,
University of Alberta, Edmonton]

**

Michael F.D. Polanyi, PhD.
Asst. Prof., Faculty of Kinesiology and Health Studies
Research Faculty,
Sask. Population Health and Evaluation Research Unit
University of Regina
Regina, Saskatchewan
S4S 0A2
Tel: (306) 337-2437
Fax: (306) 585-5694
email: [log in to unmask]
website: www.spheru.ca

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