The Toronto Globe and Mail -- Canada's "Newspaper of Record" has been
notorious for ignoring any mention of broader determinants of health.
Wednesday, they had one of their almost daily reports on obesity -- this
time a report from the Heart and Stroke Foundation that -- obesity was now
the #1 Public Health Issue in Canada.

SDOH subscriber Michael Polanyi submitted and had published the following
letter.

My letter sent today follows.  Consider submitting your own.
[log in to unmask]

Also consider a comment directly to the editor Edward Greenspon
[log in to unmask]

dr
---------------------------

What about poverty?
By MICHAEL POLANYI

Regina -- Re Fat 'The New Tobacco,' Heart Group Warns (Feb. 11): You
rightly include diet, physical activity, emotional problems, medication use
and illness among your "top 10 reasons" people gain weight, but you fail to
mention the one factor that underlies all these: poverty.

Poor adults and children are more likely to be obese because they cannot
afford healthy food and recreational opportunities and they are more likely
to be physically ill, depressed and stressed out.

Indeed, low-income children have been found to have raised levels of
cortisol in their bodies, which contributes to obesity directly by
increasing fat deposits and, indirectly, by causing depression and
associated unhealthy eating.

--------------------------

Dear Editor:

Michael Polanyi's letter (Feb.13) in which he identifies poverty as a major
underlying cause of obesity raises a number of fundamental questions about
the causes of disease in Canada and how it is understood. First, let me
point out that Dr. Polanyi's analysis is absolutely correct. Additionally,
poverty is the major underlying cause of heart disease, diabetes, and a
wealth of other diseases that so preoccupy Canadians nowadays.  The
additional questions are:
1.  Why has the Globe and Mail -- despite its accomplished and
knowledgeable public health reporter -- never once covered the relationship
between poverty and health?
2.  Why do disease organizations such as the Heart and Stroke Foundation
continue to limit their analysis of the causes of disease to the "holy
trinity of risk" of tobacco, diet, and activity?
3. Why do we hear nothing from our elected officials about the broad causes
of disease despite Health Canada's turning out of reams of docments since
the 1970's on just these issues? And finally,
4. Why is this the case for virtually all public health units in Ontario
despite similar proclamations identifying poverty as a major determnant of
health by the Canadian Public Health Association?

Dennis Raphael
Associate Professor
School of Health Policy and Management
York University, Toronto

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