So, if smoking has no effect on health, should all of those people who
successfully sued the tobacco industry for deceptive marketing of products
that addict and kill, give back the money? (I happen to support billionaires
giving back profits to their customers, many of whom live in poverty.)
I do believe that smoking effects your health. Do I think it is the only
thing? No. Do I think I can save the world one smoker at a time? No.
To me, tobacco control is social justice. Let me explain, please, before you
laugh. The recent signing of the WHO international health treaty - Framework
Convention For Tobacco Control- is about controlling an industry that
manipulates the global economy, and thus health. It is about building
healthy public policy in order to prevent companies from profiting off of
people by killing them. It is not about pointing fingers and telling
everyone, "Quit, it's bad for you! You're just to dumb to know!"
I work in tobacco control AND I make every effort to approach my work from a
social determinants of health perspective. I can honestly say that a number
of my colleagues do the same.
Becky Freeman
-----Original Message-----
From: Dennis Raphael [mailto:[log in to unmask]]
Sent: Wednesday, July 09, 2003 7:28 AM
To: [log in to unmask]
Subject: Re: poverty and health
Lindsay McLaren <[log in to unmask]>@YORKU.CA> on 07/09/2003 12:16:36 AM
Please respond to Health Promotion on the Internet <[log in to unmask]>
Sent Health Promotion on the Internet
by: <[log in to unmask]>
To: [log in to unmask]
cc: (bcc: Dennis Raphael/Atkinson)
Subject poverty and health
:
Hello, I'm interested in a response (perhaps from Dr. Raphael or other
experts in poverty and health) to a couple of naive questions:
1. We know that poverty (including all synonyms) and health are related.
However we also know that behaviours (diet, exercise) are related to
health. Is it assumed, or known, that reducing poverty or evening out
inequalities leads to reduction in prevalence of unhealthy behaviours? If
an individual moves from poverty to middle class, do we know that he/she
will stop smoking, eating poorly, and being sedentary?
Behaviours don't really matter, income and status, employment, childcare,
and
other socia factors are the prime determinants of population health. Moving
people in and out of employment are incredible determinants of health having
impacts that put the questionnable lifestyle data to shame. See Widening Gap
by
Mary Shaw et al., Policy Press.
2. I was reading a little bit about income experiments (child care
subsidies, tax credits for poor families, housing allowances) that took
place in the US mainly during the 1970s. In general, these studies had
little or mixed impact on 'health' outcomes measured - such as low birth
weight and school attendance, and actually had some negative outcomes such
as increased marital dissolution (the ones that targeted "in-tact"
families).
As Davey Smith points out giving people money in a society that is whacked
by
racism, inequality and other ills is like giving people three hours a day of
Head Start and then sending kids back to crime-wracked ghettos and then
being
surprised that there are no lasting effects of the intervention. In any
event,
Williams makes the case that giving money to poor people shows immediate
improvements in their health a well-being.
Many of the comments on this list suggest that elimination of poverty and
income inequalities is the solution to health - but I'm not clear on how the
above points are dealt with.
As I document in "Social Justice is Good for our Hearts" available at my
website, the data on lifestyle and its relationship to health is contested,
of
generally low magnitude, and ambiguous at best as compared to income and
other
societal determinants. Indeed, it is increasingly clear -- and well
accepted by
European nations that the road to improving health is through social policy.
Telling people in Ontario to imprve their lifestyles is indeed like
"rearranging
the deckchairs on the Titanic." People engaged in such activities really
need
to reflect on whether they should be looking for lifeboats.
dr
Lindsay McLaren
Dennis Raphael <[log in to unmask]> said:
> Remind me again how exercising, eating fruits and vegetables, and quitting
> smoking is going to improve the health of Ontarians...
> ---------------------------
> News Release
> Released:July 08, 2003
>
> Bitter strikes, rationed services, increasing poverty
> and homelessness, and a crumbling social safety net
> legacy of Tory policies
>
> Toronto - The Ontario Conservative government's social service
> spending cuts are a false economy leading to growing poverty and
> homelessness, less home care support services, fewer affordable child
> care spaces, and increasing labour disputes in the community agency
> sector, say members of a social justice labour alliance.
>
> Many community-based social service agencies are in a deficit
> situation, and in an effort to stay afloat financially, are extracting
wage
> and benefit concessions from already low-paid workers. Bitter strikes,
> like the one now underway at Toronto's Central Neighbourhood House,
> a community agency that provides home support, shelter and youth
> services, and child care, are becoming increasingly commonplace in
> the sector.
>
> "It's important to connect the dots about how our crumbling social
> safety net is directly related to the social service policies of this
> government. Increasing poverty and homelessness, cash-strapped
> community agencies, and workers subsidizing services through wage
> rollbacks, are the result of eight years of detrimental Conservative
> social service policies and chronic underfunding," said Brian O'Keefe,
> secretary-treasurer of the Canadian Union of Public Employees (CUPE)
> at a Queen's Park media conference held today.
>
> Ultimately, the social and financial costs of the Conservative polices -
> such as increasing child poverty, lack of affordable housing and child
> care, and a growing wage gap for immigrant workers - will far outweigh
> the immediate money savings, said Jane Mercer, executive coordinator
> with the Toronto Coalition for Better Child Care (TCBCC), and Michael
> Shapcott, a researcher on homelessness and shelter with the
> University of Toronto.
>
> "The City of Toronto has cut more than 1,600 subsidized child care
> spaces in the last twelve months as a result of the shortfall in
provincial
> funding. Now another 500 are on the chopping block. Every time we
> turn around, we are losing more subsidies. Child care is a vital
> employment support for working families, and the long-term cost of not
> funding it properly is highly irresponsible," said Mercer.
>
> Since 1995, the Tory government has cut $879.1 million from provincial
> housing programs, and Ontario has lost 23,300 affordable social
> housing units.
>
> "That," said Shapcott, "is in addition to another 59,600 affordable
social
> housing units that should have been built. In the Tories' two terms in
> government, Ontario led all other provinces in cutting funding to
> housing. This is why we have growing homelessness province-wide."
> He attributes the social housing losses to the Tory decision to cancel
> government-funded social housing programs, and download the cost of
> social housing to cash-starved municipalities.
>
> -30-
>
> For more information please contact:
> Michael Shapcott University of Toronto
> Jane Mercer TCBCC (416) 538-7630
> Brian O'Keefe CUPE Ontario (416) 579-8774
> Stella Yeadon CUPE Communications (416) 578-8774
>
>
> opeiu491/EW
>
> CUPE Ontario
> 305 Milner Avenue, Suite 902
> Scarborough, ON , MIB 3V4
>
> Phone: (416) 299-9739
> Fax: (416) 299-3480
>
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