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Oct. 3, 2005. 01:00 AM

Bitter choice: Shelter or food

GARY BLOCH AND JANET MAHER

Should poor families in Toronto be forced to choose between food and
shelter?

Of course not, but this is what Toronto Public Health concludes they
must do given the state of Ontario's social safety net.

On Sept. 26, the Toronto Board of Health reviewed the 2005 Nutritious
Food Basket, and concluded that a family of four in Toronto needs
$539.60 a month to meet these basic standards. This is an increase of 17
per cent since 1999. Low income Ontarians therefore face a dilemma —
should they pay the landlord, or should they buy supper?

Accounting for inflation, assistance rates have dropped by about 30 per
cent over the last 10 years. A single person on social assistance (who
receives just over $500 for all her needs) required an additional $285
per month to purchase the Toronto food basket in 2004. Her shortfall
will be even larger in 2005.

For parents, their children's poverty has been compounded by the
provincial government's insistence on deducting the federal child
benefit from welfare cheques. What these parents know viscerally is that
their children's poverty unfairly places them at risk for preventable
illness. The evidence backs them up — study after study has shown that
poverty is one of the strongest predictors of ill health. As health-care
providers, we see the brutal impact of poverty on our patients every day.

Many social assistance recipients in Toronto have resorted to using a
little-known provision in the welfare regulations — the Special Diet
Supplement — to help shrink the gap between their welfare cheque and
their monthly bills. The way the Special Diet Supplement works is this:
Health-care providers can authorize up to $250 in additional funds per
month if they feel a patient's medical condition requires a "special diet."

Now you might say that living on social assistance should not warrant a
special diet. We would like to agree, but the poverty forced on social
assistance recipients by low welfare rates places them at such high risk
of ill health and inadequate nutrition that we believe every recipient
qualifies for the Special Diet Supplement.

This is why we will be participating today in a "hunger clinic"
organized by the Ontario Coalition Against Poverty, to take place in
front of Queen's Park. At the clinic, hundreds of Ontarians who cannot
meet their dietary needs will be prescribed additional funds to combat
their poverty.

Recognizing that the Special Diet provisions are not a long-term
solution, we hope to persuade the provincial government to increase
social assistance rates to a level where a simple nutritious diet is not
considered a luxury.

There are other ways the provincial government can reduce the burden of
poverty. It could be more aggressive in implementing the recommendations
of Deb Matthews, parliamentary secretary to the Ontario minister of
community and social services, to address the insecurities inherent in
low-wage employment, echoed just a few weeks ago by a Toronto Dominion
Bank report. The minister has agreed to reduce the clawback on earned
income (the amount a recipient can keep from part-time work while still
receiving some benefits) to 50 per cent from 75 to 100 per cent — a
positive but tiny step.

If we want to be serious addressing the challenges Ontario families face
in trying to adequately feed, dress and house their children, it is time
to improve our social safety net.

Social assistance rates need to increase by at least one-third to
reflect the prices in the grocery store. We must restore the intent of
the national child benefit, to preserve children's health, and stop
deducting it from welfare cheques And a $10-an-hour minimum wage would
bring many poor families much closer to the poverty line.

It is not too late to avert the looming health crisis posed by the
erosion of social assistance in our province. While raising rates and
easing the process of re-entering the workforce may require increased
governmental expenditure up front, we will save in health care and
support costs for decades to come. In a country like ours, it is
unacceptable that our neighbours must steal from their bread baskets to
pay the rent.

Dr. Gary Bloch is a family physician at St. Michael's Hospital and Janet
Maher is a community activist with the Medical Reform Group.

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