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Social Determinants of Health

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Subject:
From:
Dennis Raphael <[log in to unmask]>
Reply To:
Social Determinants of Health <[log in to unmask]>
Date:
Fri, 9 Jun 2006 10:41:58 -0400
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From Raphael, D. (Forthcoming, March, 2007).  Poverty and Policy in Canada:
Implications for Health and Quality of Life.  Toronto: CSPI.

Conclusions
      Poverty rates ebb and flow - within a very limited range -- as a
result of periods of economic growth and recession.  Despite the importance
of poverty as a health issues, public attention is diverted from this issue
towards an inordinate emphasis upon medical treatments, biomedical
research, and lifestyle approaches to health. If only a small proportion of
current allocations to these activities were devoted to public education
and community development activities related to raising the profile of
poverty as a public policy issue in the service of health, a sea change in
attitudes could result.  Such a sea change could lead to policymakers
beginning to address the issue of poverty in Canada seriously.  Policy
solutions to its presence are available and could be readily applied.
      It seems more probably that the future of poverty in Canada - and
associated indicators of population health and quality of life - primarily
depends upon the policy influence of political parties in federal and
provincial parliaments. In the more immediate future, NDP, Liberal, and
Bloc strength in the federal parliament could lead to poverty-reducing
policies such as the proposed national childcare program. Conservative
dominance will lead to little if any decline in child poverty rates and -
due to greater implementation of market-oriented rather than equity-based
policies - may increase these rates.
      Accumulated empirical evidence on the political economy of poverty in
developed nations indicates that in the longer term, the influence of
political parties that support reducing poverty is enhanced by
implementation of electoral reform. Harvard economists Alesina and Glaeser
have shown that poverty levels are lower and government commitments to
supporting citizens stronger when popular vote is more closely translated
into representation in houses of legislature. These analyses of the
influence of the political upon public policy towards poverty are
consistent with Canadian political experience since the end of World War
II.
      To build the support for political action in support of
poverty-reducing public policies, repeated and continued action in support
of these goals by a range of sectors are required. These actions will
provide evidence of the value of policy options to reduce poverty, build
public support for such action, and counter the forces opposed to poverty
reduction. Such an analysis sees a role for a very wide range of actors.
The goals of these actors should be to build public support for a concerted
public policy agenda of first reducing, and then eliminating the incidence
of poverty in Canada.  In the process, the health and quality of life of
Canadians will benefit as well.
      At the beginning of this volume, a news report from 1998 was
presented that had the United Nations condemning Canada for its treatment
of people living in poverty.  It seems appropriate to conclude the volume
with a news story from 2006 that has the United Nations condemning Canada
for its treatment of people living in poverty. Whether the United Nations
will issue similar reports in the future remains an open question.

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