Economic Inequality, the Health of Societies, and the Ontario Election

        When all is said and done, the Harris agenda is about inequality.  The
rich get richer and the poor get poorer.  The middle class becomes smaller
as many get pushed into poverty.  A wealth of public health research
indicates that the health and well-being of all citizens, both well-off,
and not so well-off, suffer in societies in which inequality is greater.
Why would this be so?

Economic Inequality is Associated With Lack of Health and Social Services
        Societies that tolerate high levels of inequality tend to provide less
health and social services. The means by which this relationship comes
about seem to involve the presence of smaller tax bases for the provision
of health and social services. In the Wealthy Banker's Wife: The Assault on
Equality in Canada, Linda McQuaig contrasts the European approach to health
and social services with that of the United States. Ontario society is
heading towards the American model of increasing inequality, lowered tax
bases, and decreased services. Lest Ontarians be misled to believe that
lower tax rates will benefit them, it should be recalled that virtually all
tax breaks favor the well off.  Concerning the Ontario income tax
reductions, if you were in the richest top half of 1% of families you
benefitted by $15,586.  If you were among the poorest 10% of Ontario
families you received $150. However to pay for these tax cuts,  the
services reduced were the ones most likely to be needed by those receiving
the least tax relief. Seniors, for example now must pay for drugs,  and
services such as ambulances now carry a fee. Few seniors, 21% of which in
Ontario live in poverty, benefitted much from the income tax reduction and
services tradeoff.

Economic Inequality is Associated With Decay of Civil Society
        In Unhealthy Societies: The Afflictions of Inequality, Richard Wilkinson
provides evidence of how societies with high levels of economic inequality
show characteristics of what he termed "the symptoms of societal
disintegration."  Some of these symptoms in Britain have included increased
alcoholism, crime rates, deaths by road accidents and infectious diseases,
lowered reading scores, drug offences, family functioning, and decreased
voter turnout among others. In the USA economic inequality is related to
unemployment, incarceration, homicide, low birthweight, smoking, income
assistance, use of food stamps, less spending on education, and disability.
        In Canada we see around us signs of civil decay. There are record levels
of poverty and homelessness.  Thirty seven percent of Toronto children now
live in poverty, an increase of 66% since 1989. There are decreasing
percentages of Canadians turning out to vote in elections. It is obvious to
anyone in Ontario that road behaviour has significantly decayed since the
1970's.  The idea that Ontario drivers would stop at a Stop sign or even
red lights has become an anachronism. The social safety net is clearly
fraying.  Many of us are one job loss or illness away from destitution.

Mechanisms by Which Economic Inequality Leads to Societal Disintegration
        Poverty and inequality breeds a lack of control and feelings of
hopelessness. High levels of stress produce calming behaviours such as
eating sweets and smoking.  Clearly many individuals engage in high risk
behaviours such as use of alcohol and drugs to somehow meet needs that are
not fulfilled by society.  Animal researchers have identified the
mechanisms by which chronic stress and hierarchy creates illness and
eventually death.
        Economic inequality is associated with provision of fewer services.  For
those who are not rich, the lack of such services are a clear threat to
health and well-being. Studies have found that a lack of social supports
and services contributes to the incidence of illness and death within
societies.
        Neo-liberalism -- the emphasis on the market as the arbiter of societal
values and resource allocations -- breeds social disintegration and
alienation.  An important aspect of this is the exaggerated emphasis on
reducing taxes which directly translates into both increasing economic
inequality and reduction in the institutions that help promote civil
society.  Societies with high levels of economic inequality have lower tax
bases, higher incidences of poverty, decreased labour productivity, and
higher illness levels.  All these aspects are inter-correlated, but tax
structure seems to be an important theme that runs through it. When a
society emphasizes tax decreases, inequality becomes rampant, and social
and civil structures deteriorate.

The Role of Ideology in the Harris Agenda
        The Harris government has worked hard to increase economic inequality and
remove the services and supports that make inequality bearable for some.
This government has supervised a tremendous shift of resources from the
poor to the rich through welfare reductions and income tax breaks for the
well-off. It has removed rent controls, ended social housing, reduced
social and hospital spending, removed free prescriptions for the elderly,
removed local control over the six municipalities of Toronto, cut back
spending for public transportation, reduced environmental control,
downloaded public health services, and reduced pregnancy benefits for those
on welfare.  In fact, this government has been a case study in what we call
in public health might call  "Unhealthy Communities" or "Uncaring
Communities." On June 3 vote for your health and the health of those you
care about.  Vote to remove Mike Harris.

Dennis Raphael is an associate professor of public health sciences at the
University of Toronto.

416-978-7567
home: 416-465-7455





At 10:15 AM 6/1/1999 -0400, you wrote:
>The OPHA Violence Prevention Workgroup is in the process of preparing a
>position paper on the role of public health in violence prevention.  Does
>anyone know of any research/ statistics/ literature reviews in this area?
>
>
>Peter R. Elson
>Executive Director
>Ontario Public Health Association
>468 Queen St. East Suite 202
>Toronto, Ontario
>M5A 1T7
>(416) 367-3313 ext 26
>(416) 367-2844 (fax)
>e-mail [log in to unmask]
>
Visit our Web Site for Free Copies of Our Inequality and Health Papers and
Community Quality of Life Reports!

http://www.utoronto.ca/qol

  ****************************************************
   Canalising a river
   Grafting a fruit tree
   Educating a person
   Transforming a state
   These are instances of fruitful criticism
   And at the same time instances of art.
       -Bertolt Brecht
  ****************************************************

Dennis Raphael, Ph.D.
Associate Professor and Associate Director,
Masters of Health Science Program in Health Promotion
Department of Public Health Sciences
Graduate Department of Community Health
University of Toronto
McMurrich Building, Room 101
Toronto, Ontario, CANADA M5S 1A8
voice:    (416) 978-7567
fax: (416) 978-2087
e-mail:   [log in to unmask]