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http://www.theglobeandmail.com/servlet/ArticleNews/TPStory/LAC/20040916/HPICARD16/TPHealth/?query=picard

 Canada's illiteracy rate is enough to make you sick
By ANDRE PICARD
Thursday, Sep 16, 2004

 If you want your children to grow up healthy, teach them to read. Take an
active interest in their education. Encourage them to stay in school, and
to pursue a postsecondary education.

Lifestyle choices -- eating well, exercising and the like -- can make a
difference but their impact pales in comparison to the impact of literacy
and education.

In today's world, being illiterate or uneducated virtually condemns one to
poverty. And low-income individuals score poorly on virtually every
conceivable health measure.

Children born poor are the most likely to be of low birth weight. They are
far more likely to suffer from learning disabilities and traumatic
injuries.

The dirtiest and the most dangerous jobs are the lot of the working poor.
They call the most polluted and crowded neighbourhoods home.

Poverty is closely related to unhealthy lifestyle practices. People with
low literacy and little education are more likely to smoke, eat poorly, and
exercise infrequently; they are less likely to use seatbelts or bike
helmets, and less likely to breastfeed their children. Those with low
incomes are least likely to have routine screening tests, such as blood
pressure checks and pap smears. The poor suffer more stress and have less
control over many aspects of their lives, important factors in the way
diseases progress.

These interrelated and cascading lifestyle factors -- and there quickly
comes a point where choices are actually limited for those in the poverty
trap -- have a predictable result: The lower a person's education level and
the lower their income, the higher is their risk of developing diabetes,
cancer, cardiovascular disease and a host of other chronic conditions that
have an environmental component.

Being poor and poorly educated means you are far more likely to end up with
a disability and you will almost certainly die younger.

It is easy to blame the poor for their lamentable health status. But they
are, as much as anything, victims of short-sighted public policies.

Creating a healthy population requires a lot more than hospitals and
physicians. The quality of a health system cannot be measured solely on the
length of waiting lists and per capita spending.

The countries that have the best health outcomes don't just have decent
health-care services; they have extensive social safety nets and excellent
education systems.

The true failure of our political leaders in recent years has not been
inadequate funding of the health system. Money has been poured into the
health system at a prodigious rate in every jurisdiction; but that money,
by and large, has come from other areas that have a direct impact on
population health.

Cutting welfare payments to free up money for sickness care is a poor
investment; increasing student-teacher ratios so there is more money to
hire doctors is a pointless exercise.

Yet this robbing Peter to pay Paul mentality predominates, as evidenced by
the fact that, in the recent rhetorical outbursts about fixing health care
for a generation, there is nary a mention of education and social services.

And, at this week's current first ministers meeting, there has been more
talk of Canadian Idol than of literacy.

Yet, according to Statistics Canada, nearly half of Canadians have some
difficulty with reading materials encountered in everyday life.

About 22 per cent of the population falls into the lowest level of literacy
-- meaning they are unable to, for example, look at a bottle of medicine
and determine the correct amount to give a child. Another 26 per cent can
read but they can only deal with information that is simple, clearly laid
out and in familiar contexts.

In a so-called knowledge economy, this is inadequate, and frightening.

If Canadians are not literate, they cannot be health literate and, in turn,
that cannot be healthy.

Most Canadians think of the problems of illiteracy and innumeracy as remote
and trivial. They are not. The problem affects a broad swath of the
population from children through to seniors.

The level of literacy is contextual: In a wealthy country such as Canada,
we should be striving to educate a maximum number of people to the highest
levels.

Yet, millions of Canadian adults still can't read well enough to handle
seemingly ordinary life challenges such as voting, juggling prescriptions
and surfing the Net in our increasingly bureaucratic and computer-based
knowledge society.

A literate, educated citizenry is essential not only to economic
prosperity, but to population health -- and by extension the sustainability
of the health system.

There was a flurry of activity related to literacy a few years back, in the
late 1990s. But, looking back, one has to wonder what was actually done,
and what we are waiting for to act.

As Nobel Prize winner Amartya Sen says: "Literacy is freedom."

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