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Bringing Health to Poverty: A Call to Action for Health Providers

Bringing Health to Poverty: A Call to Action for Health Providers. Ashley Heaslip, B.A., MHSc (candidate) Canadian Public Health Association Conference June 2, 2008. Objectives. To examine poverty as a key determinant of health.

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Bringing Health to Poverty: A Call to Action for Health Providers

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  1. Bringing Health to Poverty: A Call to Action for Health Providers Ashley Heaslip, B.A., MHSc (candidate) Canadian Public Health Association Conference June 2, 2008

  2. Objectives • To examine poverty as a key determinant of health. • To examine specific strategies health providers can employ to alleviate the impact of poverty on their clients’ health.

  3. The Evidence on Poverty and Health Poverty in Canada Population Indicators Chronic Disease

  4. Figure 3.2: Percentage of Canadians Living in Poverty, 2004 Source: Statistics Canada (2006). Persons in Low Income Before Tax, 2004, CANSIM Tables. Courtesy of: Dennis Raphael

  5. Life Expectancy • Poorest vs. richest areas: • 5 years shorter for men • 1.7 years shorter for women R. Wilkins, et. al., “Trends in mortality by neighbourhood income in urban Canada from 1971 to 1996,” Health Reports (Stats Can), 2002: 13(Supplement).

  6. Infant Mortality and LBW • Poorest vs. richest areas: • Infant Mortality: 61% higher • Low Birth Weight: 43% higher Wilkins, et. al., 2002.

  7. Diabetes • Increase in prevalence among low income vs. high income: • Men 40% • Women 280% • For low vs. high physical activity: • Men 40% • Women 50% Douglas G. Manuel & Susan Schulz, “Chapter 4 Diabetes Health Status and Risk Factors,” in J. Hux, G. Booth & A. Laupacis, eds., The ICES Practice Atlas: Diabetes in Ontario, 2002, Institute for Clinical and Evaluative Sciences.

  8. Mental Health • Depression: Overall prevalence 9.17%; among low income 14.52% (10.79% men, 17.09% women)¹ ¹Katherine L W Smith, et. al., “Gender, Income and Immigration Differences in Depression in Canadian Urban Centres,” CJPH, Mar/Apr 2007; 98(2): 149.

  9. Isn’t it Just that Poor Health Causes Poverty? • “All [the studies reviewed] conclude that … the main direction of influence is from poverty to poor(er) health.” Shelley Phipps, “The Impact of Poverty on Health: A Scan of the Research Literature,” CIHI, June 2003.

  10. What Can We Do About It? An Example: The Special Diet Campaign and Health Providers Against Poverty

  11. Background to the Campaign • Social assistance in Ontario: • 22% rate cut 1995, 40% total decrease in real $ now • Single person on welfare in Toronto earns $569/month, needs an extra $390/month to meet basic needs • Single parent earns $1653, needs an extra $223/month • The Special Diet Supplement: Up to $250/month extra per individual recipient

  12. The Campaign • Mass assessment clinics • Advocacy: government, health organizations, media • Alliances with antipoverty groups, health orgs, communities • Education and outreach to health providers

  13. The Results • 6000+ forms signed … millions of dollars to people living in poverty • Awareness raised: government, health providers, health organizations, media/public • Mobilization of health providers and new voice in the antipoverty movement • Mobilization of low income people

  14. What Can We Do About It?? • Individual Patient-Provider Interventions • Practice Interventions • Community Interventions

  15. Individual Patient-Provider • See situation from client’s perspective … alter priorities • Limitations poverty places on patient’s ability to adhere to care: time, priorities, hopelessness, demands of social services • Assess eligibility for income supplements, Ontario Disability Support Program (ODSP), exclusion from forced work/education programs

  16. Practice Level Interventions • Information on income support programs and supplements • Contact information for welfare and housing offices, social workers, legal aid clinics, and antipoverty/advocacy organizations • Form letters, e.g. to support access to affordable housing, and to appeal rejected income supplement applications • Information on the health effects of poverty

  17. Community Level Interventions • Direct Health Services for underserved groups • Use privileged voice to speak publicly about poverty and health • Educate people living in poverty about health risks to improve their ability to advocate for selves • Participate in public events around decreasing poverty • Meet with elected representatives • Tell your clients’ stories • Conduct and support research into health and poverty

  18. THANK-YOU! Please visit our new website: www.healthprovidersagainstpoverty.ca Cumulative Patient Profile Forms, as well as Preventive Health Forms can be found there!

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