Afte the Sunday article that introduced the concept of social determinants
of health, the "Medical Reporter" in the Star reported the following.  You
may wish to contact her directly and try to straighten her out.

her e-mail is   [log in to unmask]


North backs health care findings
January 24, 2000, Toronto Star

                  Inequities found in Ontario report are not surprising to
                  some mayors

                                 By Tanya Talaga
                             Toronto Star Medical Reporter

                  A soon-to-be-released report pointing out health-care
                  inequities between the poorer regions of Northern Ontario
                 compared to the south is nothing new to the people who
live in
                  the north.

            It's very true to say health care has a different standard in
                the north than in the south,'' said Michael Power, the mayor of
              Geraldton, a city of almost 2,800 people, 880 kilometres
north of
              Toronto.

                  The Star has learned a new study reveals Ontario's north has
                  the sickest residents in the province, along with the
highest
                  death rates, compared to others in richer, southern
regions.

              The Star also reported that the study has been held back by the
              province, which has kept it sitting in boxes since the first
week
              of November, due to certain revisions.

           However, Kevin Finnerty, a health ministry spokesperson, said
           this is simply not the case. ``The report, in fact, is not yet
            complete,'' he said. ``The authors sent a letter to the
ministry on
            Dec. 15 saying they are still completing work on the report.
            Once that work is complete, it'll be released, and we expect that
             to be next month.''

            Yet Dr. Ian Johnson, primary author of the study, told The Star
            that they handed in the final copy of the report last November.

                  The authors of the report have found that people in the
north
                  seem to have more chronic diseases. They examined regional
                  data in order to make conclusions as to what factors affect
                  health. Among them are air quality, water quality, income,
                 housing, nutrition, education, exercise, smoking, drinking
and
                  employment.

                Power said a number of factors contribute to the varying
health
                  inequities.

        ``Our population is sparse. We are scattered. We tend to live in
          small communities. That is not very attractive for specialists,
           and it's been difficult to attract family doctors,'' said Power,
who
           added people normally have about a six- to eight-week wait just
           to see their family physician.

           Thunder Bay Mayor Ken Boshcoff said officials have been
           trying to meet with Ontario's Health Minister Elizabeth Witmer
           since November, to show her some solutions the community
           has come up with to improve care.


                           `We are feeling very
                           frustrated here'



              ``For things like heart disease and diabetes, there is no doubt
                  Northern Ontario has higher rates,'' he said.

            ``We have been trying for the past 2 1/2 months to meet with
             the minister to talk about this stuff, and she has refused to
meet
             with us.

            ``We are feeling very frustrated here,'' he said.

              More than one year ago, the province gave the green light for a
              new hospital in the area, but since then, Thunder Bay has heard
              little else, he said.

              The City of Thunder Bay, located 1,200 kilometres northwest of
              Toronto, services a huge geographic area. For most
              communities, when it comes to trauma, people have to be flown
              there.

              In Geraldton, the hospitals are 160 kilometres apart from each
              other. Some people also don't have the financial resources to
              leave the area regularly to seek help, Power said.

              ``The difficulties all northerners face is not everybody has the
               resources and the cost of accessing is high.''




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  ********************************************************************
  Long have I looked for the truth about the life of people together.
  That life is crisscrossed, tangled, and difficult to understand.
  I have worked hard to understand it and when I had done so
  I told the truth as I found it.

  - Bertolt Brecht
  ********************************************************************

Dennis Raphael, Ph.D.
Associate Professor and Associate Director,
Masters of Health Science Program in Health Promotion
Department of Public Health Sciences
Graduate Department of Community Health
University of Toronto
McMurrich Building, Room 101
Toronto, Ontario, CANADA M5S 1A8
voice:    (416) 978-7567
fax: (416) 978-2087
e-mail:   [log in to unmask]