Health more than Health Care

• Wellbeing Toronto, an online mapping application, is a web-based measurement tool that enables access to community economic and social wellbeing indicators across City of Toronto’s 140 neighbourhoods. It provides a number of facts and measures that allows a range of users to custom select and combine data, viewing their results instantly on a map. This tool is designed to raise awareness and understanding of the different neighbourhoods that comprise the city. It is equally a support tool for Council and staff in the development of policies and programs that require a place-based neighbourhood perspective.
• So what are health inequalities? How do government policies influence whether we improve a nation’s health or make it worse? These and other questions are tackled by Dennis Raphael in this Podsocs episode.
• Fat Chance! For Evidence, One Size Does Not Fit All in the Public Health War on Obesity. A study that casts doubt on whether being overweight is associated with a shorter life span has sparked 2013’s first public health controversy—and a fiery one at that.
• See “Social Determinants of Health: The Canadian Facts” (by Juha Mikkonen and Dennis Raphael) a primer for the Canadian public which has been downloaded over 100,000 times  at http://thecanadianfacts.org.
• Empathy, dignity, and respect: Creating cultural safety for Aboriginal people in urban health care (December 2012). This report highlights some of the barriers to Aboriginal people seeking health care services within mainstream health care settings and describes key practices that are contributing to positive change.
• Making health care delivery culturally safe for Aboriginal people in urban centres (November 26, 2012) (youtube.com) We spoke with Stl’atl’imx Elder Gerry Oleman, a Community Support Worker in Vancouver about the importance of cultural competency and creating health care environments free of racism and stereotypes.
• Guaranteed Annual Income Reduces Health Care Costs (November 2012) A new study published by Canadian Public Policy reveals that guaranteed annual income could significantly reduce health care costs by improving population health.
• Royal Society of Canada Expert Panel on Early Childhood Development, Fall 2012 (a report on early child development and the impact of early adverse experiences on developmental health). Link to full report.
• See David Williams, Harvard University, A Time for Action:  the Enigma of Social Disparities in Health and How to Effectively Address Them for great review of factors related to  health status in the U.S.
• Please be advised that the ‘Canadian Index of Wellbeing’ was released  in October 2011  by the Honourable Roy Romanow and Honourable Monique Bégin. The CIW is a composite measure of wellbeing using many indicators from eight interconnected categories or domains. Whereas the GDP has been measuring the economic status of Canada, the CIW now complements this as a composite measure that looks much more broadly at the ‘wellbeing’ of Canada.
• Penny Sutcliffe, MD, MHSc, FRCPC shares a recent video developed by the Sudbury & District Health Unit as part of their ongoing public health efforts to improve health equity: Let’s start a conversation about health…and not talk about health care at all. This is a five minute video highlighting that HEALTH is about much more than access to medical care. It highlights that everyone has different opportunities for health, largely influenced by their social and economic conditions. Using this broad view of health, the video describes actions that various non-health sectors can take. It encourages everyone – teachers, builders, dads, nurses, business women, students, politicians… to start a conversation about health… and not talk about health care at all. Dr. Sutcliffe would be very pleased to hear your feedback at startaconversation@sdhu.com
• Webinar: Looking Upstream: How Income, Education and Racial Inequalities Shape Health. On April 26th, the Robert Wood Johnson Foundation hosted a webinar on the effects that income, education and race have on health.
• How does Canada fare on actual health outcomes relative to its neighbour to the south? “Quite well” according to the Conference Board of Canada. The Conference Board argues “improving the health status of Canadians requires improving social and economic conditions, educating the population to reduce risks of chronic diseases (for example, by limiting tobacco and alcohol consumption and by being physically active), and enhancing the quality and safety of health care.”
• The Bayview medical clinic in San Francisco is developing a new kind of pediatric medicine, focusing on childhood trauma as a medical issue. Dr. Burke, clinic founder, argues that childhood trauma has a strong impact on adult health. See the March 2011 New Yorker article by Paul Tough which reviews the Adverse Childhood Experience study and describes the powerful relationship between poverty, child development and health.
• If anything the gaps in health status across income groups are widening, not narrowing, and this is not because of poor access to healthcare. The universal Canadian system does a good job of delivering healthcare to those who need it and who can benefit from it, but there is more to being healthy than healthcare. Manitoba Centre for Health Policy researchers looked at the distribution of disease, death and the use of preventive healthcare across income groups in Manitoba. They found that the growing gap in income was accompanied by profound and growing gaps in health.
• Improving the health of Canadians requires we approach health and its determinants in a more thoughtful manner than has been the case to date. Mikkonen and Raphael’s Social Determinants of Health: The Canadian Facts considers 14 factors that affect health including income and income distribution, education, unemployment and job security, employment and working conditions, early childhood development, food insecurity, housing, social exclusion, social safety network, health services, aboriginal status, gender, race and disability. The publication outlines why they are important and how Canada is doing in addressing them.
• It turns out there’s much more to our well-being than genes, behaviors and medical care. The social, economic, and physical environments in which we are born, live and work profoundly affect our longevity and health―as much as smoking, diet and exercise. This is a story about health, but it’s not about doctors or drugs. It’s about why some of us get sicker more often and die sooner and what causes us to fall ill in the first place. This series by Public Broadcasting Service in the U.S , UNNATURAL CAUSES, criss-crosses the country investigating the stories and findings that are shaking up conventional notions about what makes us healthy or sick.
• Researchers in the US estimate that over the period 1996 through 2002 medical advances saved a maximum of 178,193 lives. They also estimated how many lives would have been saved if mortality rates among US adults with an inadequate education had been the same as rates among adults with 1 or more years of college. Changing US society to eliminate deaths associated with disparities in education would have saved 1,369,335 lives during the same period, a ratio of 8 to 1.
• Unless governments change their approach to addressing the needs of poorer and socially disadvantaged Canadians, we are destined to continue to spend a large amount of dollars on our healthcare system. Governments must expand their approach to health promotion in order to tackle the major societal factors that lead to poor health and to take pressure off healthcare budgets.
• Recommended reading on Healthcare Costs/Spending from the Canadian Institute for Health Information (CIHI)

From the Health Council of Canada:

• Understanding and Improving Aboriginal Maternal and Child Health in Canada. Aboriginal Canadians have significantly worse health and more challenging living conditions than the rest of the population. With a much younger demographic and a higher birth rate than the non-Aboriginal population, the Health Council of Canada set out to learn about programs and strategies that have the potential to reduce these unacceptable health disparities.

• See more recommended reading from the Health Council of Canada.

Our Commentaries

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  Download our free ebook! Canadian Health Policy in the News: Why Evidence Matters
  By Noralou Roos, Sharon Manson Singer, Kathleen O’Grady, Camilla Tapp and Shannon Turczak
  Canadian Health Policy in the News is a compendium of the commentaries (or OpEds) we have published in major newspapers across the country since the birth of EvidenceNetwork.ca in April 2011 up to October 2012.
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  How toxic stress is hurting our children
  By Nicole Letourneau and Justin Joschko
  For most parents today, stress is a constant companion. Everyone’s heard of the dangers of high blood pressure, of chronic workaholics having heart attacks at forty, of harried professionals pouring themselves an extra glass of wine (or three) with dinner.
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  Why a doctor prescribes tax returns
  By Gary Bloch
  Tax season is upon us and my practice is humming. I am not an accountant, I am a family doctor. My patients are not bank executives, they are largely people who live in poverty, many who are homeless and on social assistance.
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  Why we all discriminate — even our doctors
  By Stephen Hwang
  We sometimes imagine that discrimination is a blight confined to earlier times and far-away places. Unfortunately, discrimination — that is, treating people better or worse simply because they are members of a particular socially-defined group — occurs in every aspect of our lives today, from the workplace to the doctor’s office.

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