The Record (Waterloo Region)
  Local, Thursday, April 10, 2003, p. B6

  Income has biggest impact on health, professor says

  NICOLE MACINTYRE
  RECORD STAFF

  WATERLOO - An ambulance pulls up to the emergency room doors with a patient
  suffering a heart attack inside. Is the patient a Bay Street trader or a
blue-collar worker
  from a lower-class area?

  While many would pick the high stress trader as the prime candidate, it's
actually more
  likely the patient is from a lower socio-economic class, Dr. Dennis Raphael
told a
  group of about 25 people yesterday at the University of Waterloo.

  "There's a perception out there that heart disease is a middle-class disease,
and it's
  not."

  When it comes to almost any medical condition, income is the number-one
determinant
  of health, the associate professor in the school of health policy and
management at
  York University explained. That smashes the myth, Raphael said, that exercise,
 good
  nutrition and not smoking are the keys to good health.

  "It's not lifestyle, although it certainly doesn't help to be doing these
things."

  Countless studies and reports have proven a person's level of wealth dictates
their level
  of health, Raphael said. But despite the facts, he said, the government and
health
  officials continue to state that lifestyle is the major factor in good health.

  "The dominant message being put out is you are responsible for the state of
your own
  health," he said.

  Raphael said that becomes particularly problematic when considering people who
 are
  poor. Is it not unreasonable, he asked, to expect a cab driver working 14
hours a day
  to exercise when he gets home?

  "You end up blaming them for their own problems."

  If the government wants to improve society's overall health and the burden on
the
  health care system, it would be better to address poverty. Improving funding
to
  programs like affordable housing and welfare would have significant trickle
down
  effects for the whole system, he said.

  Currently the government is misplacing funding and only adding to the problem,
  Raphael argued. Rather than funding breakfast programs for children not
getting a meal
  at home, why doesn't the government give a mother an extra five dollars so she
 can buy
  her own cereal.

  "The solution is to give them enough money so they don't run out of food," he
said,
  pointing to the need for more efficient funding.

  The government has repeatedly acknowledged the effect of social factors on
health, but
  so far it has done little to implement change, Raphael said.

  It's a stagnation Denise Wamsley feels personally. As a program developer with
  Opportunities 2000, a local anti-poverty group, she's continually lobbied
government
  to raise the standard of living.

  The research is there to support such a move, Wamsley said. It's just a
question of
  convincing policy makers to do something.

  "The process of change is so long," she said with evident frustration.

  [log in to unmask]

  Category: News
  Uniform subject(s): Diseases, therapy and prevention; Health and social
services;
  Laws and regulations
  Story type(s): News
  Edition: Final
  Length: Medium, 368 words





© 2003 The Record (Waterloo Region). All rights reserved.


Dennis Raphael, Ph.D.
Associate Professor & Undergraduate Programme Director
School of Health Policy & Management
Atkinson Faculty of Liberal & Professional Studies
York University
4700 Keele St.
Toronto ON M3J 1P3
Ph: 416-736-2100 ext. 22134
Fax: 416-736-5227
E-mail: [log in to unmask]
Website: http://quartz.atkinson.yorku.ca/QuickPlace/draphael/Main.nsf/