I have just spent a weekend in Aylmer Quebec with many hardworking
leaders in the cancer community and made an impassioned case for
supporting the SDH in our Canadian Strategy for Cancer Control. I also
had Dennis's coaching on a letter I hand delivered to the secretary to
the Minister of Health (MP Steven Fletcher) and hand delivered a copy of
that letter to the Minister of Health, Tony Clement. (see below for the
text from that letter).
I sincerely believe that although big money is an issue, we need to
become peaceful, respectful activists that go forth and create
relationships with leaders who are working hard but may be misinformed,
distressed or of another mind set, and go about the difficult task of
finding common ground respectfully but courageously. Kind of a Martin
Luther King jr non-violent movement with clear, good thinking, good
intention and suggestions for policy change.
And as my sphere of influence unfolds, and the relationships I am
creating unfold, it is looking hopeful that some key leadership folks
are listening, and with collective will, I am hopeful the cancer
community will take the lead in addressing the SDH aspects of the
chronic diseases. ie: by addressing poverty etc. Here is my lettter:
22 February, 2006
Mr. Steven Fletcher
Member of Parliament
Parliamentary Secretary to the Minister of Health and
to the Minister for the Federal Economic Development Initiative for
Northern Ontario
3111 Portage
Avenue Unit A
Winnipeg, MB R3K 0W4
Dear Mr. Fletcher
I warmly applaud you and thank you for championing the Canadian Strategy
for Cancer Control (CSCC).
Every day I work with cancer care medical colleagues who work hard for
an extra 5-10% improvement for outcomes for patients who are downstream
with the disease of cancer. I am a counsellor, in a social work &
nutrition department within a cancer clinic, who listens to, and
advocates for, families facing emotional and financial struggles,
sometimes at the end of life. As a direct result of my counseling
experience I have become an advocate for prevention, working upstream
with cancer care. This also means I have become an advocate for strong
leadership regarding our social and physical environment.
There are some big ways we could improve levels of disease in our
country by about 30%, according to Dennis Raphael, professor at the
School of Health Policy and Management, York University. In fact, the
kind of changes I'm referring to will not only decrease disease rates,
but will also reduce the incidence of crime and economic
un-productivity. This is a tremendous three-for-one cost savings.
The single best predictor of where people will sit on an illness -
health continuum is their socioeconomic status. In other words, the
single best predictor of health is a person's or family's living
conditions. Living conditions are about meeting basic needs by having
enough money (a "living" wage), a decent place to live and being able to
take care of each other when they need to (ie: throughout childhood,
elder care, during times of crisis, change or illness). We need to
support families so that they can do their job well. It may seem
"expensive" to support families with adequate resources, but if we
don't, the costs of running the country on skimpy social budgets is
staggering.
International statistics indicate that Canada has a larger proportion of
families living under unhealthy living conditions compared to many other
developed countries. Our child poverty rates are 15-17% (with the US at
21% and Mexico at 27 %, as compared to Scandinavian countries with 2 to
4 %)*. Four years ago I was working in a family support agency affected
by Gordon Campbell's cutbacks to social programs. The writing was on the
wall. My colleagues and I looked at each other and said "The crap is
going to hit the fan in this province". We were working hard everyday
with largely low income families helping them to cope with challenges.
Now we are wondering what to do about homeless youth and it is
absolutely no surprise to me that the BC Ministry of Children and Family
Development is under scrutiny for the death of 19 month old Sherry
Charlie, who died in 2002 after being placed in the custody of an uncle
with a history of violence and spousal assault. Why should a ministry of
over worked social workers be hung out to dry for a leadership decision
to cut service? Paying for another government commission is not the
answer. Funding the programs is the answer. Remember the three for one.
We simply have to get everyone educated fast on how to lead this kind of
social and economic change effort.
In fact, that is one of the primary reasons I am enthused about the
National Cancer Leadership Forum. Visionary leadership by Dr. Simon
Sutcliffe, a symphony of 45 different agencies working together, and
fearless training and recruitment of grassroots leaders (thanks to Pat
Kelly), to support a solid plan with a prevention focus. Dr. Sutcliffe
once said to me, as I prepared a presentation on this topic for my
colleagues: "The biggest improvements in health are a result of social
change."
Chronic diseases are linked at the social determinants of health, the
root system that feeds a tree of ailments. Cancer is one of those
ailments. The Population Health Template provides direction for tracking
key elements and actions
(http://www.phac-aspc.gc.ca/ph-sp/phdd/pdf/discussion_paper.pdf).
I am hopeful that through your influence and leadership we will see the
immediate and long range benefits of supporting the "social determinants
of health" through policy change including environmental (ie: ensuring
knowledge of toxic products gets to employees and employers, pesticide
use) and social programs (ie: adequate food, housing, shelter and
education).
In my experience people are more apt to make healthy lifestyle choices
if they have the resources to do so. And it is much easier to help
people make healthy choices if they have enough in the way of financial
resources. Throw in universal access to education and our hopefulness
and prosperity just might go through the roof. I find people to be
enormously resilient, creative and hard working if given the right
environment.
In my view of the world, leaders have an obligation to be stewards for
our social and physical environments while facing the bluster of
economic globalization that tends to let market forces create unstable
job situations, less pay and benefits, and poorer working and
environmental conditions. I see our leaders as stewards for a human
petri dish called Canada, a place where people can grow in optimum
conditions. Improvement in individual lifestyle choices will follow.
I hope your government will take up the social and environmental issues
that will create a Canada that is an optimum environment for growth,
resiliency and creativity. Economic prosperity will follow. Isn't it
nice to know that something so intuitive is backed by research, although
this research needs champions like you. I would be glad to forward you a
copy of Dennis Raphael's "Social Determinants of Health - Canadian
Perspectives" that has tremendous lists of resources both nationally and
internationally.
Your courage to be a voice for the CSCC has inspired my hopefulness.
Thank you.
Sincerely,
Shannon Lavell, RN BSN MA
705 Sutherland Avenue
Kelowna, BC, V1Y 5X4 Ph: (250) 860-4994 Email:
[log in to unmask]
* Child Poverty in Rich Countries 2005:
http://www.unicef.org/brazil/repcard6e.pdf
cc: The Honourable Tony Clement, Minister of Health and the Minister for
the Federal Economic Development Initiative for Northern Ontario
-----Original Message-----
From: Social Determinants of Health [mailto:[log in to unmask]] On Behalf Of
Dennis Raphael
Sent: Sunday, March 05, 2006 5:49 AM
To: [log in to unmask]
Subject: Re: [SDOH] my letter to the Globe and Mail this morning
I recall reading "Living Downstream" a number of years ago and having
the
same response: I think the Cancer Society follows the money: the money
available is to blame people for their illness, absolving regulators and
governments of any responsibility...
http://www.amazon.ca/exec/obidos/ASIN/0375700994/701-2438581-6191547
Living Downstream: a Scientist's Personal Investigation of Cancer and
the
Environment
by Sandra Steingraber (Author)
http://www.steingraber.com/
http://www.oriononline.org/pages/om/06-1om/Steingraber.html
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