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  • Photograph by Elizabeth Roth

Counterpoint: Growing income gap a health risk

On March 3, Upstream made the Financial Post. 

More specifically, a graphic we made about income inequality and health appeared above an article by Peter Shawn Taylor.

However, there were some pretty big holes in Taylor's assertions. Today, Ryan Meili addresses these gaps in his rebuttal in the Financial Post. 

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In his article “Death by one-percenter,” Peter Shawn Taylor makes a very strange argument. He suggests that physicians and public health experts, charged with caring for the health of Canadians, should not concern themselves with the root causes of illness and stick to a narrow range of health interventions.

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 Fortunately, Canadian health experts have a broader and more complete understanding of how and why people get sick

Fortunately, Canadian health experts have a broader and more complete understanding of how and why people get sick. They aren’t satisfied with simply pulling drowning kids out of the river; though this is obviously important, they also look upstream to ask why kids are falling in the river in the first place. Decades of studies have shown conclusively that income and its distribution, education, employment, housing, food security and the wider environment have far greater impact on health outcomes than health care. I see this borne out daily in the lives of patients whose life circumstances have limited their ability to enjoy full health.

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 Taylor belittles this well-established and supported concept of the social determinants of health as “impossibly broad.” It’s true that these upstream factors touch on all aspects of public policy. Our health is determined by political choices. If we want the best for Canadians, shouldn’t our political choices be determined by health?

If we want the best for Canadians, shouldn’t our political choices be determined by health?

There is a growing international movement, supported by the World Health Organization, toward “Health in all Policies,” an approach that has been adopted by governments around the world. Here in Canada, Quebec has such a policy, and Newfoundland and Labrador are currently exploring this model.

Taylor takes particular umbrage with an idea that has been expressed most clearly in the British Medical Journal: “The more equally wealth is distributed the better the health of that society.” There are three key ways in which wealth inequality can lead to worse health outcomes. The first, and most obvious, is poverty. In a less equal society, more people live in relative disadvantage and are less able to afford safe housing and nutritious food or to access educational and economic opportunities. Their health suffers as a result, with people living in poverty often having life expectancies 20 or more years shorter than wealthier citizens. In my inner-city neighbourhood of Saskatoon that manifest in rates of diabetes, heart disease, STIs, infant and overall mortality many times greater than the rest of the city.

Continue reading Ryan's rebuttal in the Financial Post here.

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Curious about the original article that raised Taylor's ire?

The Effects of Income Inequality by Dennis Raphael and Toba Bryant.

 

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