PUBLICATION        The StarPhoenix (Saskatoon)
DATE               Fri 22 Oct 2004
SECTION/CATEGORY   Forum
PAGE NUMBER        A11
BYLINE             Dr. Cory Neudorf

   HEADLINE: Health costs hurting battle against poverty

   The following is the opinion of the writer, Saskatoon's chief
   medical health officer.

   The relationship between poverty and health is an issue that needs
   attention in Saskatoon.

   Health status reports from Saskatoon and from the Canadian
   Population Health Initiative, as well as many research
   publications, all show that poor socio-economic status leads to
   poor health.

   No matter what measure is used, it is clear that people who are
   poor suffer more from poor health.

   For example, lower income groups have lower life expectancy and
   higher rates of most diseases. Chronic diseases (arthritis,
   rheumatism, diabetes, heart problems, cancer and hypertension) are
   twice as common for Aboriginal persons, but most of this
   difference is related to the lower average income experienced by
   this group.

   And infant mortality is higher in the low- income neighbourhoods.

   Disability is more common among people with low incomes (32 per
   cent for men, 28 per cent for women) than people with high incomes
   (12 per cent of men and 16 per cent for women).

   Lower income groups tend to have higher rates of smoking and
   certain other negative health behaviours.

   The research that highlights the linkages between poverty and
   health is growing and we should be proud that Canada is playing a
   lead role internationally in studying these linkages and proposing
   potential solutions.

   But, while the relationship between poverty and health is becoming
   ever clearer, the questions it raises for resource allocation and
   revenue generation are complex, fraught with ideological debates
   and lend themselves to conflict and public controversy.

   This is an important debate to have so we can work through the
   complexities.

   We must move beyond the "crisis" in health care and begin building
   healthy communities to correct these health inequities. To do this
   we should think more seriously about progressive tax policies that
   provide the needed resources to support a good quality of life for
   everyone.

   The public also needs to consider the implications of our demands
   on the health system.

   For example, we already enjoy good access to high tech diagnostic
   and treatment services and waiting times are being managed at a
   safe level.

   The costs of adding more expensive equipment to further reduce
   wait times may speed the system up for a short while, but at what
   cost? Less services in prevention? Less money for education or
   social services?

   How much will further improvement in this area affect the overall
   health of our population, or reduce costs compared to investments
   in other areas of society?

   Many new drugs that are being developed are primarily enhancements
   of old drugs, with fewer side effects, but at increased cost. How
   much does funding these new drugs contribute to further improving
   the health of our community?

   Also, there is a great deal of local public attention focused on
   surgical waiting lists and the quality of care at emergency rooms.
   While we need to ensure waiting lists for surgery don't get too
   long and that we continue to have safe care in emergency wards,
   this must be balanced with waiting lists for social housing,
   prevention programming and lineups at food banks.

   The number of requests to the Saskatoon food bank rose by almost
   12 per cent between 2002 and 2003.

   If we supported the well being of our communities, we would
   consider progressive tax policies and a resource allocation system
   focused on dealing with the other growing waiting lists.

   Such a shift in approach requires a change in what society asks
   its governments to fund.

   Evidence from certain European countries shows that where wealth
   is distributed more equitably, the health gap between the rich and
   poor is smaller and overall population health is better.

   The fact that we have as much inequity as we do is inexcusable and
   unnecessary in a country like Canada. It is a matter of choices.
   Poverty makes me sick -- because poverty makes those experiencing
   it sick.

   To have healthy communities we need to deal with the inequities.
   We need to break from some of the old patterns that have been
   established and use more creative approaches to ensure there is a
   balance between health system resources allocated to prevention
   and population health with that allotted to treatment and
   diagnostic services.

   We have to ensure health system costs don't overwhelm our ability
   to fund the other "health" services -- such as social services,
   education, and employment. Until government feels that the public
   is demanding this balanced approach to funding, the current
   pattern will not change.

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