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- Page navigation anchor for RE: There are valid reasons to invest appropriately to alleviate overall poverty and specifically child poverty in Canada.RE: There are valid reasons to invest appropriately to alleviate overall poverty and specifically child poverty in Canada.
We applaud the timely commentary and wholeheartedly agree that there are good ethical reasons to reduce inequality in Canada. Further, we certainly agree with Dr. Hancock and the cost of health inequality is substantial, both in years of life lost and costs to the Canadian economy (1). It is also a significant challenge to Canadian healthcare system. Therefore, there are valid reasons to invest appropriately to alleviate overall poverty and specifically child poverty in Canada. Reducing the number of Canadians living in poverty including our vulnerable children should be a social policy priority. Even though, child poverty in Canada and this theme able to grab much public, media and political attention, according to recent statistics Canada, there were 4.8 million Canadians living in a low income household in 2015, of whom 1.2 million (nearly one in four) were children (2).
Recently, the Word Health Organizations’ concluded that "social injustice is killing people on a grand scale"(3). There is a rationale for action to improve the lives of those living in poverty. Social determinants and health inequalities pose a significant challenge to health care systems around the world.
Meanwhile, OECD has concluded, “failure to tackle the poverty and exclusion facing millions of families and their children is not only socially reprehensible, but it will also weigh heavily on countries’ capacity to sustain economic growth in years to come.” (4).
Pov...
Show MoreCompeting Interests: None declared. - Page navigation anchor for RE: Reducing the cost of inequality by inequityRE: Reducing the cost of inequality by inequity
Thank you to Dr. Hancock for his editorial “Reducing the Cost of Inequality. “ (CMAJ 2018 January 22; 190: E92).
Dr. Hancock, an international respected leader in public health, brings attention to a significant under recognized apart of the Canadian healthcare system. The health of vulnerable populations. Dr. Hancock focuses specifically on the inequality of Indigenous People in Canada. As Dr. Hancock points out in a country as wealthy as Canada this is a continuing and persisting inequality. However, I would challenge that this is further than an inequality that simple economics can fix but this is inequity. More than simple resource allocation but a social justice and fairness what are arguably true Canadian values which Dr. Hancock does allude to. As an Indigenous physician I have seen first hand the devastating effects of poor health of Indigenous People’s directly due to colonization, residential schools, racism and stereotypes, which keep’s us all from obtaining this health inequity. What really needs to be done is what the Truth and Reconciliation Commission (TRC) concluded a paradigm shift in an ‘us versus them’ attitude among Canadians must change. Further, there is no better place to start than health care. The tragic case of Brian Sinclair, an Indigenous man, who died in a Winnipeg ER waiting room; should have been a clear wake up call that inequality in itself will not be sufficient. A real shift in the ‘hearts’ of Canadians must occur and as physicians...
Show MoreCompeting Interests: None declared. - Page navigation anchor for Reducing food insecurity and improving health with a basic income guaranteeReducing food insecurity and improving health with a basic income guarantee
I read with interest Dr. Trevor Hancock’s commentary, “Reducing the cost of inequality,” which argues that poverty in Canada is now so expensive we cannot afford it (1). Public health teaches us that tackling poor health outcomes ascribed to poverty - particularly those faced by Indigenous people - necessitates acting on upstream causes of inequality. As Dr. Hancock notes, public health is naturally eyeing innovative policies like the guaranteed income (or basic income guarantee) as a means to improve health and offset the exorbitant costs of poverty.
As a negative income tax, a basic income guarantee works like this: if your income is below a specified threshold, you are topped up by a “no strings attached” government cash transfer. The poorest Canadians get the maximum transfer and the richest get nothing. No one falls below an after-tax minimum income.
One way a basic income guarantee may improve health outcomes is by reducing food insecurity, which is defined as inadequate or inconsistent access to nutritious food due to financial barriers. Canada’s northern and Indigenous communities are especially prone to food insecurity. Almost 26% of off-reserve Indigenous households are food insecure compared to 12% of all households in Canada (2). In Nunavut, where nearly 47% of the population is food insecure, groceries often cost two to three times more than the national average (3).
Poor access to nutritious food negatively affects physical, mental and ps...
Show MoreCompeting Interests: None declared.