Who will champion the CMA’s health policy recommendations?
The Canadian Medical Association, which has lately been taking a far more social determinants-focused approach to health, has come out swinging with a report clearly titled “Health Care in Canada: What Makes Us Sick?”, which identifies poverty as one of four fundamental factors external to the health care system that underlie ill health among Canadians.
The report includes some really interesting positions including calls for a health impact assessment to accompany Cabinet decision-making.
Of course, the CMA is not the first body to make poverty less a moral issue and more a question of evidence-based medicine, maintaining a sustainable health care system, and sound health policy (it should be noted that the report in question is not a medical study but is rather an expression of public views on the social determinants of health as collected in town hall sessions across the country). If MPPs and MPs get behind the CMA’s recommendations—a fabulous issue for the polls!—they don’t need to re-invent the wheel. The Wellesley Institute, for example, has promoted a social determinants of health approach to health policy for many years and has come out with some important publications on the topic that support the CMA’s report with more detailed research and recommendations.
In this paper published this May, the Wellesley Institute compare health equity-promoting strategies from different Canadian regional health authorities. The range of health-promoting strategies considered in this report echoes the CMA’s concerns in at least some respects. For example, the authors take a look at different approaches to early childhood development and Aboriginal health.
The CMA’s 12 policy recommendations for improved health across the population are as follows:
That the federal, provincial and territorial governments give top priority to developing an action plan to eliminate poverty in Canada.
That the guaranteed annual income approach to alleviating poverty be evaluated and tested through a major pilot project funded by the federal government.
That the federal, provincial and territorial governments develop strategies to ensure access to affordable housing for low-and middle-income Canadians.
That the “Housing First” approach developed by the Mental Health Commission of Canada to provide housing for people with chronic conditions causing homelessness should be continued and expanded to all Canadian jurisdictions.
That a national food security program be established to ensure equitable access to safe and nutritious food for all Canadians regardless of neighbourhood or income.
That investments in early childhood development including education programs and parental supports be a priority for all levels of government.
That governments, in consultation with the life and health insurance industry and the public, establish a program of comprehensive prescription drug coverage to be administered through reimbursement of provincial– territorial and private prescription drug plans to ensure that all Canadians have access to medically necessary drug therapies.
That the federal government recognize the importance of the social and economic determinants of health to the health of Canadians and the demands on the health care system.
That the federal government require a health impact assessment as part of Cabinet decision-making process.
That local databases of community services and programs (health and social) be developed and provided to health care professionals, and where possible, targeted guides be developed for the health care sector.
That the federal government put in place a comprehensive strategy and associated investments for improving the health of Aboriginal people that involves a partnership among governments, non-governmental organizations, universities and Aboriginal communities.
That educational initiatives in cross-cultural awareness of Aboriginal health issues be developed for the Canadian population, particularly for health care providers.
Now it remains to be seen who will take this on as an election issue. It would be nice to see some cross-party support for an issue that affects all Canadians--and the integrity of the health care system in a time when chronic disease and economic insecurity are both on the rise.
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