June 24, 2013

OTTAWA – The Canadian Medical Association wants parliamentarians to consider the role poverty plays in health outcomes as well as demands on the health care system.

The CMA president Dr. Anna Reid urged members of the All-Party Anti-Poverty Caucus (APAPC) June 4 to consider the "social determinants of health."

"Poverty makes people sick," Reid told the dozen or so MPs and senators from the APAPC.


Reid spoke of her experience as a doctor in Yellowknife where many of her patients have diabetes or pre-diabetes but no money to buy nutritious food. They are worrying about where to sleep and what to eat.

"There is no way they can properly manage diabetes."

The circumstances of one's day to day existence determine whether one is healthy or sick, she said.

Poorer people have a lower life expectancy, a higher disease burden than wealthier people, she said. That contributes to higher rates of hospitalization and mental health admissions "which could potentially be avoided with proper primary care."

Twenty per cent of health care spending goes to care for disease that can be attributed to low income and poor housing, she said.

Reid urged greater attention to the "upstream factors" that affect health.

The poor are the most in need of good health care but least likely to have access to either primary care physicians or specialists, she said. They are also less likely to have access to pharmaceuticals not covered by the public health system.

The CMA has conducted town hall meetings in various regions of the country since February, and it kept hearing Canada cannot have a healthy population without eliminating poverty, Reid said.


A Hamilton, Ont., study revealed that residents in a wealthy neighbourhood had a life expectancy of 83 while those in the lowest-income neighbourhoods had one of only 62, she said.

"Adverse socio-economic conditions in childhood can be a greater predictor of cardiovascular disease and diabetes in adults than later life circumstances and behavioural choices," she said.

"Countries reporting highest population health status are those with the greatest income equality, not the greatest wealth," she said.

The CMA made seven recommendations for governments at all levels to examine to improve health outcomes.

  • A comprehensive prescription drug strategy in consultations with the life and health insurance industry to ensure that the 10 per cent of Canadians who lack access to prescription drugs can get them.
  • Ensuring low-income Canadians have access to rehabilitation, mental health, home care and end-of-life care.
  • Exploring options for funding long-term care services such as public insurance schemes or registered savings plans.
  • Expanding relief programs for informal caregivers such as family members caring for aging parents or a disabled child.
  • Recognizing "the importance of the social and economic determinants of health to the health of Canadians and the demands on the health care system."
  • Require federal cabinet decision-making to include a health impact assessment.
  • Have the federal government "give top priority to the development of strategies to minimize poverty in Canada."

Members of APAPC said they hoped to bring recommendation five, recognizing the importance the economic determinants of health, to their respective party leaders.