This is a very significant action in Canada.  Thank you to Gary Bloch and
the other organizers and the signatories of this letter. - dr
-----------------------------------------
September 8, 2005

Honourable Sandra Pupatello
Minister of Community and Social Services
80 Grosvenor St, 6th Floor, Hepburn Block
Toronto ON
M7A 1E9
[log in to unmask]

Dear Minister Pupatello:

We are a group of health care providers and professionals from across
Ontario who care, collectively, for thousands of the poorest Ontarians.  We
are writing to express our concern about the health effects of the poverty
in which many of our patients live.  As you know, welfare rates in Ontario
were cut drastically in 1995, and have fallen steadily relative to their
spending power in the ten years since.  This has left our patients who live
on social assistance without enough money to pay for even their most basic
needs, such as food, shelter, and clothing.  We believe this constitutes a
health crisis.

The link between poverty and ill health is supported by strong evidence.
We know that people who live in poverty are at significantly higher risk
for developing, and dying from, illnesses such as diabetes, cancer, and
heart disease.  Given the strength of this evidence, we believe it is our
professional obligation and ethical responsibility to address poverty as a
risk factor for ill health.

You may have heard of the current initiative by health care providers to
approve the special diet supplement for all welfare recipients.  As poverty
is one of the strongest risk factors for serious illness, it constitutes a
legitimate, and preventable, "medical condition", justifying the
prescription of the full supplement to every person on social assistance.
We now have experience with thousands of our patients who have received
this supplement, and who report a powerful impact on their, and their
families', ability to meet their nutritional and health needs.

We do not believe this effort should ultimately have to be carried forward
by health care providers, however.  The issue of poverty can and should be
addressed in the legislature, not in our offices.    Welfare rates have
fallen by a third or more in spending power over the past ten years.  These
rates now place most recipients' income at less than half the poverty line.
According to Toronto Public Health, a single person living on welfare is
$285 per month short of being able to afford the recommendations for a
nutritious diet contained in Ontario's Nutritious Food Basket. Welfare
rates in Ontario must be raised across the board, to show that our
government, and our society, is not willing to allow our poorest neighbours
to continue to live at high risk of ill health.

We are writing to enlist your support in improving the health of our
province's poorest families, by working to increase welfare rates to a
level that meets their basic needs.

We would appreciate the opportunity to meet with you to discuss our
concerns, and to discuss how we can work together to address this crisis.
Please contact us through Dr. Gary Bloch at [log in to unmask]

Thank you for your attention to this urgent matter,

Gary Bloch MD CCFP, St. Michael's Hospital, Seaton House Homeless Shelter
(for)

Linda Alldred-Johnson, Parish Nurse, St Matthew's United Church, Richmond
Hill
Peter Barreca BSc MD CCFP FCFP, St Michael's Hospital, Assistant Professor,
University of Toronto
Ahmed Bayoumi MD FRCPC, University of Toronto
Marg Benzie PHN, Region of Peel Outreach Team
Philip B. Berger MD CCFP FCFP, Medical Director Inner City Health Program,
Chief Department of Family & Community Medicine, St. Michael's Hospital
Andrew Bond MD, Resident in Family Medicine, St. Michael's Hospital
Toba Bryant PhD, Centre for Research on Inner City Health, St. Michael's
Hospital
Mark D. Caspi, Therapeutic Counselor, Shout Clinic
Viola Coleman RN, Shelter Health, Region of Peel
Barb Craig RN, Street Health
Cathy Crowe RN, Street Nurse, Atkinson Economic Justice Fellow
Gary Deonarain, RN, Salvation Army Harbourlight Centre
Mimi Divinsky MD CCFP FCFP, Medical Reform Group
Monika Dutt MD, Resident in Family Medicine, St. Michael's Hospital
Brenda Everett, Administrative Coordinator, Central Toronto CHCs, Shout
Clinic
Adeline Falk-Rafael RN PhD, Associate Professor, Nursing, York University
Joyce Fox RN BScN MHS, Director, Healthy Living Service, Simcoe Muskoka
District Health Unit
Dorothea Fox Jakob, R.N.
Charles Gardner MD, Medical Officer of Health and CEO, Leeds, Grenville and
Lanark District Health Unit
Miriam Garfinkle MD CCFP, Regent Park CHC
Michael Garreau, President Canadian Nursing Students' Association, Co-Chair
New Health Professionals Network
Abbas Ghavam-Rassoul MD MHSc CCFP, St. Michael's Hospital and The Centre
for Addiction and Mental Health
Rick Glazier MD MPH CCFP FCFP, St. Michael's Hospital
Kevin Gough MD FRCPC M.Ed, Assistant Professor, University of Toronto, Head
Division of Infectious Diseases, Medical Director HIV Service St. Michael's
Hospital
Nancy Graham RN BScN, Public Health Nurse, City of Toronto
Doris Grinspun RN MSN Ph.D. (cand) O.Ont., Executive Director Registered
Nurses' Association of Ontario
Gordon Guyatt MD FRCPC, McMaster University
Ted Haines MD, McMaster University
Abby Hershler MEd MD, Psychiatry Resident
Stephen Hwang MD MPH FRCPC, Associate Professor Dept. of Medicine,
University of Toronto, Research Scientist, Centre for Research on Inner
City Health, St. Michael's Hospital
Sarah Innis RN, Street Health
Tara Kiran MD CCFP
Wendy Lai MD CCFP
Peggy Lathwell MD, Regent Park CHC
Joan Lesmond RN, Casey House
Rhonda Love PhD, Professor, Dept. of Public Health Sciences, University of
Toronto
Janice Meilach, Counselor, Queen West CHC
Peggy Millson MD MHSc FRCPC, Associate Professor, Dept. of Public Health
Sciences, Faculty of Medicine, University of Toronto
Nabil B. Missiha MB BCh CCFP FCFP, St. Michael's Hospital
Alicia Odette RN, Street Health
Rosana Pellizzari MD, Medical Officer of Health, Perth District Health Unit
Judith Peranson MD, Resident in Family Medicine, St Michael's Hospital
Deb Phelps RN, Health Promoter, Queen West CHC
Neena Prasad MSc MD CCFP, St. Michael's Hospital, Queen West CHC
Kapri Rabin, Health Services Director, Central Toronto CHC
Dennis Raphael PhD, Associate Professor, School of Health Policy and
Management, York University
Meb Rashid MD CCFP, Access Alliance Multicultural CHC
Lynn Rempel RN PhD, Assistant Professor Department of Nursing, Brock
University
Pete Sarsfield MD FRCPC, Medical Officer of Health and CEO, Northwestern
Health Unit
Dyanne Semogas RN, Assistant Professor, McMaster University, Project
Director Wesley Managed Alcohol Program
Leah Steele MD PhD CCFP, St. Michael's Hospital, Centre for Addiction and
Mental Health, Methadone Works, Toronto Public Health
Jim Sugiyama MD CCFP, Taddle Creek Family Health Network
Penny Sutcliffe MD MHSc FRCPC, Medical Officer of Health and CEO, Sudbury &
District Health Unit
Tomislav Svoboda MD CCFP FRCPC, Medical Director Seaton House, St.
Michael's Hospital, Centre for Research on Inner City Health
Judy Tsao MSW, Outreach Counsellor, Queen West CHC
Jolanda Turley MDCM CCFP, St. Michael's Hospital, Assistant Professor
University of Toronto
Karen Weyman MD CCFP FCFP, St. Michael's Hospital
Roland Wong MSc MD FRCPC, Community Medicine Specialist, Toronto
Susan Woolhouse MD CCFP, South Riverdale CHC
Anita Young RN, Street Health

cc:   Hon. George Smitherman, Minister of Health and Long Term Care
Hon. Jim Watson, Minister of Health Promotion
Dr. Sheela Basrur, Chief Medical Officer of Health
Michael Prue, NDP Critic Community and Social Services
Gerry Martiniuk, PC Critic, Community and Social Services
Shelley Martel, NDP Critic, Health and Long Term Care
Elizabeth Witmer, PC Critic, Health and Long Term Care

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