The Toronto Star News Story
October 28, 2000

Jim Coyle

Off the beaten campaign trail: The real story

LAST WEEK, the leaders of our three levels of government -
Mssrs. Chr‚tien, Harris and Lastman - gathered at a dockside
pub to announce an investment to redevelop Toronto's
waterfront.

It was a glorious day, marred only by the trio's orgy of
self-congratulation, a cheesy smarm-fest that may well be
unrivalled in this country since that night 10 years ago that
Brian Mulroney and the first ministers emerged from a week
behind closed doors to announce what big guys and great
Canadians they all were and that they had saved (pride
going, as usual, before the fall) the Meech Lake Accord.

Over and over again, the unlovely trinity of Jean, Mike and
Mel referred to each other as ``best buddies.'' The Prime
Minister, rarely one for originality, chirped something about
them being ``the three amigos.'' To listen to it - and the
dutiful yuks of the assembled sycophants from their staffs -
was very nearly to retch.

Even so, and even though the investment had already been
widely reported, they did not want for an audience, the media
crammed in cheek by jowl, the better that footage, photographs
and fulsome prose could be dispatched in large and gushing
quantities to a waiting public.

This week, Canadian Alliance Leader Stockwell Day was inspired
to examine the performance more than two decades ago of the
Prime Minister while he was finance minister. Even though the
turbulent economic conditions of the '70s seem hardly
comparable to the good times of today, even though the
remembrances of such times past seem to plague few Canadians
beyond Rod Love and Jason Kenney, Day's rummage through the
archives was widely and thoroughly reported.

On Monday, Dennis Raphael was in Ottawa.

As far as can be divined, hardly anyone noticed.

By now, of course, the University of Toronto professor of
public health is surely accustomed to toiling in obscurity. He
speaks about poverty, about its effects on health, about the
fact the former has profound implications on the latter.

As a consequence, he tends to receive vastly less attention
than, oh, the latest legal adventures of our local bondage and
discipline queen or fresh trends in thong underwear.

On Monday past, Raphael was addressing the annual meeting of
the Canadian Public Health Association. What he said was
pretty simple. Given that election campaigns are being waged
both federally and municipally, some of it might be worth
repeating.

That low income and poverty are determinants of poor health is
now uncontested, he said. Whatever indicator of health is
used, those who live in poverty are worse off.

Simply put, economic inequality is bad for a society's health.
Furthermore, economic inequality tends to increase (we said
this was simple) in societies which provide increasing
financial gains for the well-off at the expense of
the poor. And though the economic pie has increased in recent
decades, the gulf between the wealthy and everyone else has
been widening relentlessly across many industrialized nations.

Those who live in the most disadvantaged circumstances have
more illnesses, more disability and shorter lives than the
more affluent. In comparisons between poor children and those
not living in poverty, health differences show up in ``the
incidence of illness and death, hospital stays, accidental
injuries, mental health and well-being, school achievement and
drop-out, family violence and child abuse.

``In fact, poor children showed higher incidences of just
about any health-related problem, however defined,'' he said.

``Yet government policies at every level seem to be at odds
with these concepts. And in fact, seem designed to weaken
population health.

``The health consequences of so many Canadian children and
families living in poverty will be manifest for the entire
next generation,'' he said. ``And considering the magnitude of
the increases in child and family poverty, such consequences
pose direct threats to the sustainability of the health-care
system.''

Raphael notes that much of the attention of Canadian public
health is focused ``downstream'' - which is to say in tobacco,
drug and alcohol use, sexual practices, diet and activity.
This does not deal with the problem at source, he says.

``Make no mistake about it: Poverty is the cause of many of
the health-related issues and behaviours with which health
workers concern themselves.''

Obviously sensitive to the tenor of the times, Raphael even
casts the issue in terms of self-interest.

There's increasing evidence, he says, that societies with
greater numbers of poor people begin to show deteriorating
health results even among the well-off. The British Medical
Journal has said that what matters in determining mortality
and health in a society is less its over-all wealth than how
evenly wealth is distributed.

The essentials of improved public health are pretty much
agreed, Raphael noted. They are: peace, shelter, education,
food, income, a stable ecosystem, sustainable resources,
social justice and equity.

These don't seem to be things you hear much about from the
three amigos - or anyone else on our busy campaign trails.

It's a funny old world, Maggie Thatcher once said.

Election campaigns are no time to discuss serious issues, Kim
Campbell famously observed during one.

Looks like they were both right.


Jim Coyle's column usually appears Tuesday, Thursday and
Saturday.