Today's Inequities (Blog post #4)

In last week’s blog post I spoke of how income is an important determinant of health. I didn’t, however, give examples of how this is true. To elaborate on this, I will speak of last week’s lecture material from FNN 400 and from FND 401 (Social & Cultural Dimensions of Food).

In FND 401, I learned about “health disparity” and “health inequity”, where health disparity is defined as a “disproportionate disease burden among population groups”, while health inequities are the “causes of health disparities”. This relates to last week’s lecture on social inequities. The primary inequity boils down, once again, to income. There is a large gap between the very poor and the very rich, which is becoming bigger as time progresses. There have been attempts made to decrease this gap by increasing minimum wages. This, however, is insufficient.

Many businesses that pay employees minimum wage are retail and grocery stores. Speaking from experience, minimum wage increases didn’t always benefit the employee. I used to work at Metro grocery store for nearly three years of my life. As a student and a part-time worker I would get thrilled when minimum wage was going to increase. I would think to myself, more money in my pockets. However, as minimum wage increased, so did my union dues and a decrease in available hours in the departments. It didn’t affect me much because I had the second highest seniority, and thus the number of hours per week I was scheduled remained nearly unchanged. My circumstances aren’t exactly generalizable to the rest of minimum wage workers, because I was a student who couldn’t work many hours in the first place. Some people were scheduled less hours, and no longer benefited from the minimum wage increases; some were worse off.

What other things can we do to make all equal, to eliminate the gap between the Rich and Poor, and thus increase the health in the lower socio-demographics? In class we spoke of also increasing social assistance, make food, housing and day care more affordable, and increase health and recreational activities. However, who will pay for all of this? Will the Rich be good Samaritans and put more money into these concepts? One way this can potential happen would be to speak to the emotions of the Rich.

An issue I can see arise from this is the potential of an increased tension between the Rich and Poor. It is possible, that that the Rich may feel like they have a right to make all the important decisions, an example would be could be where the affordable houses will be built. Will the Rich feel like they are superior to the Poor, and act as if they were their saviour? If the Rich think they aren’t benefiting as well, would they retract their donations? Either way, I don’t believe I will see this in my life time or for at least many years from now.

If we can’t reduce the social inequalities, we must find a way to reduce these relationships.  The relationships explored in class included those between income inequalities and Physical Health, Mental Health, Obesity, Violence, and Teenage Births.

Sources:

FNN 400 lecture notes, week 5

FND 401 lecture notes

Money = Health?

“Do not wear yourself out to get rich; have the wisdom to show restraint. Cast but a glance at riches, and they are gone, for they will surely sprout wings and fly off to the sky like an eagle” - Prov 23:4-5

This verse, from the New International Version Bible, tells us that we shouldn’t thrive to be rich. Although being rich would be nice, there are more important things: our health. However, there is a correlation between ones health and income.  This is evident when you look at The Social Determinants of Health 10 Tips to Better Health (Raphael, 2005). All 10 tips have one common theme, something that ties them all together: socio-economic status. This means that money does matter.

However, you may be thinking: doesn’t everyone, no matter their socio-economic status, have the same access to health care through Medicare? Indeed, that  is true. Matter of fact, those with a lower socio-economic status visit physicians and hospitals more often than those with higher socioeconomic status, but that is only because they are getting sicker (Picard, 2011). Although Medicare offers the same health care access to all Canadians, the problem is that the other social determinants of health are not being addressed; they all lead or spin out of low socio-economic statuses.  Is this reminding you of last week’s post?  I hope so.  I am once again going to talk about health promotion.

You’ve probably noticed a trend, that I have a strong opinion about health promotion.  I think health promotion is very important in creating a health Canadian population. The Globe and Mail’s André Picard tells us readers  that  many of Europe’s countries spend less on healthcare, but more on social welfare than Canada, and still have greater health outcomes (2011). That tells me that these European countries are targeting more so the social determinants of health, and thus health promotion is greater. It would be interesting to see how they manage to allocate their financial resources into the social welfare programs, and who are they targeting with these programs.

I wonder if Canada were to apply the same approaches as Europe, would similar results occur? In the short term, the answer would be no, because changes in policies and distribution of funds to health promotion takes time to see it increase the overall health of Canadians. Also, with Canada having such a great diversity in race, ethnicity, and culture in comparison to each individual European country, a greater difficulty will arise during the planning stages. An ethical dilemma may arise if all Canadians are treated in the same way without taking into consideration the implications of either using an upstream or downstream approach.

In my opinion, something that needs to happen with an increase in health promotion is an  increase of choice. By allowing Canadians to chose whether they want to participate in health promoting activities or not, without victim blaming, we may create stronger communities. Perhaps, those who previously would have decided not to participate may see the benefits of living healthier lifestyles through their neighbours, and thus will make the decision to make the same lifestyle changes. This may seem like wishful thinking, but it needs to happen for Canadians to live longer and healthier.

Maybe one day socio-economic status will no longer be a social determinant of health.

Sources:

http://www.acts17-11.com/money.html

http://www.theglobeandmail.com/life/health/andre-picard/universal-health-care-scores-well-but-dont-be-deluded/article1892275/

FNN 400 week 4 lecture notes

Health Promotion is on my Mind

In today’s blog, I want to discuss health promotion and different parties that may be involved. What many do not know is only about “5% of total health care funding goes to public health.”   Public health is responsible for health promotion and prevention; it looks at keeping Canadians healthy and thus reduces the burden on the health care system with sick individuals.  Why is it only 5%? The reason is there is a greater focus on treatment, which can be measured; unlike its siblings health promotion and prevention where we cannot definitely state it caused individuals and communities to remain healthy.  Nonetheless, more funding should be given to public health. 

Can businesses help Canadians improve their health? What about Wal-Mart? Recently in the National Post, it was reported that the U.S. First Lady Michelle Obama has teamed up with Wal-Mart to make “healthier” foods more affordable to Americans. Wal-Mart will “reduce fats and sugars in packaged food and cut the price of fruits and vegetables”. I consider this health promotion because it is seeking to decrease the economic barrier that inhibits low-income families from choosing to eat a well-balanced meal. Thus, it is targeting two of the 12 social determinants of health: income and income distribution, and food insecurity.

What are Wal-Mart’s motives? Is it truly to help Americans live healthier lives? Maybe not.  Businesses wants to create a clean image, to give their customers what they want, and thus potentially increase their sales. However, I do applaud Wal-Mart. Will this development cross over the border? Will Canadians see the same healthier options? If so, how much of an effect will it have on Canadian populations? I can say it depends. I do not think it will impact all Canadians. Take Downtown Toronto as an example. How many Wal-Marts can you find Downtown? None. Would a Wal-Mart ever be built Downtown? It is very unlikely, because there simply isn’t any room for one to be built. What about the current grocery stores located Downtown? Can they create a plan similar to Wal-Mart’s? It may be possible, but it may take a long time for such developments to occur.

What implications will this have on me? As a nutrition student and a future nutrition professional, I feel like my duty is to promote health. Independent of whether the food industry does or does not improve the contents of their packaged foods (i.e. less sodium and sugar), I need to educate family, friends, and clients (individuals or communities) how to read food labels to make healthier choices between similar foods.  I already attempt to choose healthier alternatives for myself, but I also know the economic barriers that prevent this from occurring. Thus, I also need to account for these economic  factors in future practice.

For those of you who haven’t seen the latest public service announcement from Health Canada, I’d like to leave you with the video . This is a way that Health Canada is trying to help Canadians chose healthier options, and thus, promoting health.

Sources:

http://www.nationalpost.com/news/world/First+lady+makeover+Mart+food+aisle/4141744/story.html#ixzz1CxESJoHF

Lecture notes from January 26^th, 2011

http://www.youtube.com/watch?v=J860Sim0hyQ