The Chronicle-Herald
 Opinion, Tuesday, September 9, 2003, p. B2

 Poverty and poor health: the gathering storm

 Katherine Reed

 THE RECENT provincial election campaign has confirmed one of
 my worst fears. As I read and listened to the candidates, it was
 disturbingly clear that few of Nova Scotia's public policy
 decision-makers recognized, or had any plan for addressing, one
 of the most significant pressures on our health care system:
 poverty.

 Candidates expressed concern about the links between physical
 fitness and health and the increasing prevalence of serious
 diseases among Nova Scotians. They acknowledged the growing
 health care demands of aging baby boomers and the shortage of
 health care personnel. They all cited the need to improve health
 services, reduce wait lists and purchase badly needed equipment,
 while keeping health spending in check.

 What they failed to talk about is the impact on health care costs of
 the ever-increasing numbers of poor people in Nova Scotia, the
 intensification of this poverty, and the well-established link
 between poverty and poor health. The logic is hard to ignore:
 More poor people and poorer poor people equals more ill health
 which demands higher levels of spending on health care services
 and drugs. Doesn't that sound expensive?

 We tolerate high levels of poverty in this province, particularly
 among unattached individuals, women, members of visible minority
 groups, aboriginal peoples and people with disabilities. Those who
 are poor are very poor. An article in the July 19, 2001, edition of
 this paper quoted a GPI Atlantic research paper as saying, "Nova
 Scotia's poor are the poorest in Canada" and "The average income
 for the poorest 20 per cent of the province's population was
 $8,205 in 1998."

 The National Council of Welfare reported in 1999 that 16.9 per
 cent of Nova Scotians had pre-tax incomes below the Statistics
 Canada low-income cut-off lines. For unattached individuals, that
 figure jumped to 41 per cent.

 Housing research in 2000 by Grant Wanzel and Orenda O'Brian
 Davis indicated that in 1996, 30 per cent of Nova Scotians were
 renting their housing and 59 per cent of those renters lived on
 incomes of less than $15,000 per year. Based on a total
 population of 900,000, that works out to about 160,000 people.

 The link between poverty and poor health is well-understood.
 Health Canada states, "Research indicates that income and social
 status is the single most important determinant of health." (They
 list a total of 12 determinants.)

 To cite a concrete example of the poverty-health care spending
 link, a national study discussed in a GPI Atlantic report dated
 February 2000 reported, "Men age 15-39 with inadequate income
 were 46 per cent more likely to be hospitalized than men with
 adequate income. Poor women were 62 per cent more likely to be
 hospitalized than non-poor women. As hospitals are the single
 largest health care expenditure, strategic investments that alleviate
 poverty are likely to be highly cost effective in the long run."

 In spite of this kind of compelling and widely available information,
 policy-makers fail to recognize the potential for poverty alleviation
 to reduce health care spending. They don't seem to understand
 that it is useless to talk about smoking cessation without
 considering the crushing stress that poor people live with year in,
 year out. Politicians acknowledge that proper diets are important
 for good health, but they insist on trimming social assistance food
 allowances. For many of the working poor and welfare poor,
 unaffordable housing also takes a big bite out of already
 inadequate grocery budgets. Yet investing in more affordable
 housing has clearly not been a priority for any level of government.

 Early detection and treatment of serious disease is a high priority.
 Ask any politician or medical professional. Yet there is no
 allowance for basic transportation or telephone service in social
 assistance budgets and we have precious little in the way of
 affordable public transportation infrastructure around the province.
 These are just a few examples of our penny-wise, pound-foolish
 public policies.

 Much poverty in Nova Scotia could be eliminated by raising the
 minimum wage. We maintain the third-lowest minimum wage in the
 country at $6 per hour. The rate is not indexed for inflation and
 increases are minuscule (and usually concurrent with election
 campaigns). The Canadian Centre for Policy Alternatives points
 out that minimum wage has roughly 25 per cent less buying power
 today than it had 25 years ago and they estimate that about 15,000
 Nova Scotians are earning minimum wage. We cannot escape the
 need to raise minimum wage immediately, by one dollar at the very
 least.

 It is within governments' power to take targeted measures to
 address these economic conditions that cause poor health, but
 they just don't seem to get it. In fact, the measures taken in the past
 couple of decades - cuts to social assistance and affordable
 housing spending, and tiny increases in the minimum wage - have
 us rolling quickly backward. Dare I even mention the erosion of
 access to higher education for lower-income people and the
 student debt burden? Incidentally, educational attainment is another
 significant factor that determines health and economic well-being.

 I find it positively maddening to watch the policy-makers hammer
 away year after year at the same wrong-headed approaches to our
 economic and social problems, in spite of a mountain of evidence
 pointing in the opposite direction. I sincerely hope, for all our
 sakes, that with this new minority government in place, they can
 find a way to correct the course and avert this calamity.

 Katherine Reed is a social policy observer and works at the
 Antigonish Women's Resource Centre. The opinions expressed in
 this article are her own and do not necessarily reflect those of her
 employer.

 Category: Editorial and Opinions
 Uniform subject(s): Health and social services
 Length: Long, 769 words

 © 2003 The Chronicle-Herald - Halifax. All rights reserved.

 Doc.: 20030909HH0Sep9_txt0046

To unsubscribe send one line: unsubscribe click4hp to: [log in to unmask] . To view archives or modify subscription see: http://listserv.yorku.ca/archives/click4hp.html