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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:
Tue, 27 Jan 2004 16:30:28 -0500
Content-Type:
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Maybe all your hounding is getting through, Dennis! A Toronto Star
columnist is covering SDOH.

  Diana Daghofer. The Alder Group, [log in to unmask]
  -------------------------
  Interesting question embedded within the article of whether we need to
  give more money to low income people or put more money into services?

  dr
  ----------------------------------
   Jan. 23, 2004. 01:00 AM
  `Incredible investments' wasted

  http://thestar.ca/NASApp/cs/ContentServer?pagename=thestar/Layout/Article_PrintFriendly&c=Article&cid=1074813008207&call_pageid=971358637177


  CAROL GOAR

By David Reid's estimate, Canadian taxpayers spend between $6 billion and
$10 billion a year, fighting child poverty.

 He doesn't think they're getting their money's worth.

 It frustrates him, as director of education for the Toronto District
School Board, to watch Ottawa and Queen's Park hatching
 programs and designing delivery systems, as if child welfare had nothing
to do with public education.

 Local schools, he contends, are the best place to help kids who need a
decent meal, a safe place to play, a foothold in a new
 country or bit of stability in their lives.

 It angers him, as a citizen and public official, that Toronto's schools
sit unoccupied 88 per cent of the time, while policy-makers
 talk about building new recreation centres, creating new child care spaces
and putting social services in accessible locations.

 "The school is the ideal community resource for those things," he says.
"We should take advantage of the incredible investments
 we've already made."

 Reid made his remarks last week at a round table on child poverty,
organized by the Institute for Research on Public Policy.
 His intervention was a refreshing ? and practical ? change from the
statistics-laden presentations of most of the panellists.

 "I look for opportunities to speak at gatherings like this," Reid said in
an interview. "As the largest school board in the country,
 we want to be part of the debate.

 "But I have yet to read a substantial document that talks about
integrating schools into social policy."

 There are two principal reasons for this, in Reid's view.

 The first is that governments are organized into rigid silos. The
bureaucrats who deal with education have little to do with the
 bureaucrats who manage social assistance.

 To complicate matters further, the issue of child poverty straddles
federal, provincial and municipal jurisdictions. There is too
 much protocol and too little honest conversation. "I wish we could just
park the idea that it is an infringement on the provinces'
 constitutional role for an educator to talk to Ottawa," he said.

 The second problem is money. The Toronto public school board can barely
afford to provide its students with essential
 services, let alone take on new responsibilities.

 No one is more aware of this than Reid. He was the one who eliminated 500
jobs by offering early-exit packages to
 secretaries, teaching assistants and lunchroom supervisors last spring. He
was the one who appealed to teachers to help pay for
 the board's classroom nutrition program, last fall. He was the one who
jacked up user fees for school playing fields to $9.33 an
 hour last winter, driving out community sports, boys and girls' clubs and
day camps.

 "It's offensive," he agreed. "We should be using these facilities 365 days
a year."

 The way to make that happen, Reid submits, is to stop walling off school
from the rest of a child's life and stop separating
 education from the rest of family policy.

 "My hope is that we can start to redefine the mission of public education
as a community resource that engages parents and
 children from birth notice to school leaving," he said. "The longer we
have to work with kids and parents, the better the chances
 of getting successful results."

 He envisages early learning centres in every school; health and dental
clinics operating out of schools; municipal agencies
 moving into underutilized school space; cities running their recreation
programs out of schools; and social services being offered
 in schools.

 Where the city would get the money to lease hundreds of school playing
fields and gymnasiums is an open question. When the
 province will invest in the 270,000 new child care spaces that Premier
Dalton McGuinty promised is a matter of speculation.
 Then there are all the logistical problems associated with moving medical
facilities, municipal offices and social service agencies
 into schools.

 Moreover, there is the deeper issue of how best to fight child poverty.

 If the most effective approach is to put money into the hands of
low-income parents, expanding the role of schools would have
 little impact.

 If the best strategy is to remove the barriers that are holding kids back
? hunger, isolation, lack of stimulation in early
 childhood, domestic upheaval, inadequate language skills, development or
health problems ? the education system should be
 central.

 Obviously, it's not an either-or proposition. Kids need both financial and
social support to reach their potential. They need
 stable homes and strong schools.

 Reid doesn't claim to have all the answers. He just wishes the discussion
weren't going on in so many airtight compartments. He
 wishes the infrastructure that Canadians have built for their children
could be used properly. He wishes the policy wonks who
 analyze child poverty would lift their heads out of their studies and
examine all of the tools that exist to help disadvantaged kids.

 Is he seeking more money, influence and prominence for the Toronto
District School Board? Probably.

 Is he raising questions that belong on the national agenda? Without a
doubt.

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