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Address disparities in public health
Feb. 10, 2006. 01:00 AM

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Speed up sluggish health-care reform
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Editorial, Feb. 8

I was excited to read the Health Council of Canada is advocating for a
reduction in "blatant inequalities in health." To my disappointment,
however, as I read further it became evident that inequalities in health
care were the main focus of this editorial. While this issue deserves
attention, it is unfortunate that too often we equate health with health
care while ignoring other, more important determinants of health.
Inequalities in health are a major problem in Canada, with those of lower
socio-economic status experiencing lower life expectancy and higher
mortality from virtually every illness compared to those who are better off
financially. Research has shown that the provision of health care is
generally ineffective in decreasing these inequalities, particularly in a
country with a universal primary health system.

If we hope to address this issue, more important determinants such as
poverty, housing, education, and child development must be put on the
political agenda. Some nations, such as the Nordic countries, have a long
history of striving to minimize inequality, and as a result, boast some of
the highest life expectancies in the world. In contrast, the United States,
despite spending more per capita on health care than any other developed
country, has a miserable record for addressing broader determinants of
health.

In Canada, an almost exclusive focus on reducing wait times completely
ignores what causes people to get sick in the first place, which is of much
greater importance in creating and perpetuating health disparities.

Why do we allow more than 800,000 people to use a food bank each month,
almost one in five children to live in poverty, and decade-long wait lists
for rent-geared-to-income housing? It is these types of issues which
require action in order to minimize inequalities. Pumping more money into
health care is not the answer.


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Kathryn McGoldrick, Toronto

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