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Govind Rao

Not just justice: inquiry into missing and murdered Aboriginal women needs public healt... - 0 views

www.cmaj.ca/...E78

from heather aboriginal gender violence

shared by Govind Rao on 15 Mar 16 - No Cached
  • CMAJ March 15, 2016 vol. 188 no. 5 First published February 29, 2016, doi: 10.1503/cmaj.160117
  • On Dec. 8, 2015, the Government of Canada announced its plan for a national inquiry into murdered and missing indigenous women and girls, in response to a specific call to action from the Truth and Reconciliation Commission.1 On Jan. 5, 2016, a pre-inquiry online survey was launched to “allow … [stakeholders an] opportunity to provide input into who should conduct the inquiry, … who should be heard as part of the inquiry process, and what issues should be considered.”2 We urge the federal government to be cognizant of the substantial knowledge, skill and advocacy of those who work in public health when deciding who should be consulted as part of this important inquiry.
  • A recent report from the Royal Canadian Mounted Police3 confirmed that rates of missing person reports and homicide are disproportionately higher among Aboriginal women and girls than in the non-Aboriginal female population. As rates of female homicide have declined in Canada overall, the rate among Aboriginal women remains unchanged from year to year. This is troubling, and the need to seek testimony from survivors, family members, loved ones of victims and law enforcement agencies in the inquiry is clear.
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  • However, we should avoid diagnosing this problem merely as a failure of law enforcement. Murders represent the tip of an iceberg of problems related to endemic violence in communities. Many Aboriginal women and girls, and indeed men and boys, live each day under the threat of interpersonal violence and its myriad consequences.
  • Initial statements from the three federal ministers tasked with leading the forthcoming inquiry — the ministers of Indigenous and Northern Affairs, Justice and Status of Women — suggest that its purpose is to achieve justice, to renew trust between indigenous communities and the Canadian government and law enforcement bodies, and to start a process of healing.
  • The inquiry surely must also endeavour to lay the groundwork for a clear plan to address the broader problem of interpersonal violence, which, in turn, is rooted in several key determinants. Addressing interpersonal violence is not merely an issue of justice; it is also a public health concern.
  • Factors associated with both the experience and perpetration of interpersonal violence are manifold. They include but are not limited to mental health issues, drug and alcohol misuse, unemployment, social isolation, low income and a history of experiencing disrupted parenting and physical discipline as a child. The Truth and Reconciliation Commission’s report has highlighted that many of these factors are widespread in the Aboriginal populations of Canada.4 Many of the same factors contribute to disparities between Aboriginal and non-Aboriginal peoples in areas such as education, socioeconomic circumstances and justice. T
  • here is also substantial overlap with identified determinants of poor health in Aboriginal communities both in Canada and elsewhere.5,6 These are the factors associated with higher rates of youth suicide, adverse birth outcomes and tuberculosis, and poorer child health. It’s clear that a common web — woven of a legacy of colonization and cultural genocide, and a cumulative history of societal neglect, discrimination and injustice — underlies both endemic interpersonal violence and health disparities in Canada’s indigenous populations. There is no conversation to be had about one without a conversation about the other — if the aim is healing — because the root causes are the same.
  • The World Health Organization (WHO) is currently engaged in developing a global plan of action to strengthen the role of health systems in addressing interpersonal violence, particularly that involving women and girls.7 A draft report by the WHO acknowledges interpersonal violence as a strongly health-related issue that nevertheless requires a multisectoral response tailored to the specific context. Evidence from Aboriginal community models in Canada gives hope for healing.
  • A recent report from the Canadian Council on Social Determinants of Health highlighted important strides that some Aboriginal communities have made to address the root causes of, and to mitigate, inequities through efforts to restore the people’s connection with indigenous culture.8 Increasing community control over social, political and physical environments has been linked to improvements in health and health determinants.
  • The public health sector in many parts of Canada has embraced the need for strong community involvement in restoring Aboriginal people to the health that is their right. In many community-led projects over the past few decades, the health care sector has worked with others to address common proximal and distal determinants of disparities.
  • We are presented with not just an opportunity for renewing trust between indigenous communities and the Government of Canada but also for extending the roles of public health and the health care sector in the facilitation of trust and healing. There is much that the health sector can contribute to the forthcoming inquiry. Health Canada should be involved from the start to ensure that public health is properly represented
Irene Jansen

Aboriginal Child Health and the Social Determinants: Why Are These Children So Disadvan... - 0 views

www.longwoods.com/21982

aboriginal determinants

shared by Irene Jansen on 23 Jan 12 - No Cached
  •  Healthcare Quarterly, 14(Sp) 2010: 42-51 Social Determinants in Context Aboriginal Child Health and the Social Determinants: Why Are These Children So Disadvantaged? Brian Postl, Catherine Cook and Michael Moffatt Canada's original people consist of First Nations, Inuit and Metis peoples. Their estimated population is 1.17 million. The total fertility rate for the period 1996–2001 was 2.6 for Aboriginal women versus 1.5 for Canada (Statistics Canada 2006). Thus, a high proportion of this rapidly growing segment of the population are children. Numerous articles have reviewed the health status of Canada's Aboriginal children and shown comparatively high prevalence and incidence of most of the common diseases that affect children. This article highlights some of the more specific disparities, but also attempts to provide some historical context and a few composite case studies that illustrate how the social determinants, colonialism, jurisdictional issues, geography and healthcare can interact to amplify disproportionately the disadvantage these children have in so many ways. Much of the historical detail recounts the contact with First Nations people, the most numerous and the first group to have contact with European settlement.
Govind Rao

Growing gap a health risk - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246200|ntnp|20150311|216151379

from heather determinants

shared by Govind Rao on 11 Mar 15 - No Cached
  • National Post Wed Mar 11 2015
  • In his article "Death by one-percenter" (March 3), 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. 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.
  • 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? 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 is 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 manifests in rates of diabetes, heart disease, STIs, infant and overall mortality many times greater than the rest of the city.
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  • With Canadians increasingly waking up to the need for an upstream approach to health and politics, those who actively oppose social investment and greater equality are sure to take aim at the notion of health as a guiding principle in public policy. This is beyond unfortunate, as addressing the upstream determinants of health can both improve the economy and the ability of that economy to provide for the well-being of Canadians. That's a hopeful and compelling idea, and, to some, a dangerous one. The fact that it's receiving so much press attention suggests it's an idea whose time has come. Ryan Meili is a family physician in Saskatoon and founder of Upstream: Institute for A Healthy Society.
Irene Jansen

WHO conference on determinants Rio October 2011 - 0 views

www.who.int/...index.html

determinants international who

shared by Irene Jansen on 23 Jan 12 - No Cached
  • a world conference on social determinants of health in Rio de Janeiro in October 2011
  • The conference will focus on five building blocks that have proven to be essential for effective action on social determinants of health: governance, participation, the changing role of the health sector, the need for global action and how to monitor progress.
Irene Jansen

Healthcare Policy, 7(1) 2011: 68-79 Population Aging and the Determinants of Healthcar... - 0 views

www.longwoods.com/...22525

demographics spending

shared by Irene Jansen on 23 Jan 12 - No Cached
    • Irene Jansen
      Irene Jansen on 23 Jan 12
       
      Rising hospital expenses, use of specialists threaten system; Aging population accounts for one third of increase, says UBC study Vancouver Sun Tue Aug 30 2011 Page: A4 Section: Westcoast News Byline: Matthew Robinson 
  • We found that population aging contributed less than 1% per year to spending on medical, hospital and pharmaceutical care. Moreover, changes in age-specific mortality rates actually reduced hospital expenditure by –0.3% per year. Based on forecasts through 2036, we found that the future effects of population aging on healthcare spending will continue to be small. We therefore conclude that population aging has exerted, and will continue to exert, only modest pressures on medical, hospital and pharmaceutical costs in Canada. As indicated by the specific non-demographic cost drivers computed in our study, the critical determinants of expenditure on healthcare stem from non-demographic factors over which practitioners, policy makers and patients have discretion.
  • research dating back 30 years illustrates that population aging exerts modest pressure on health system costs in Canada (Denton and Spencer 1983; Barer et al. 1987, 1995; Roos et al. 1987; Marzouk 1991; Evans et al. 2001; McGrail et al. 2001; Denton et al. 2009)
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  • To shed new empirical light on this old debate, we quantified the impacts of demographic and non-demographic determinants of healthcare expenditure using data for British Columbia (BC) over the period 1996 to 2006. Using linked administrative healthcare data, we quantified the trends in and the determinants of expenditures on hospital care, physician services and pharmaceuticals. To our knowledge, this is the first time that all three of these major components of healthcare costs have been analyzed in a single Canadian study.
  • our study cohort included 3,159,900 residents in 1996 and 3,662,148 residents in 2006
  • We found that population aging in British Columbia contributed less than 1% per year to total growth of expenditures on hospital, medical and pharmaceutical care from 1996 to 2006. We also found that changes in age-specific mortality rates reduced (albeit modestly) per capita healthcare costs over time, confirming what other researchers have suggested (Fries 1980; Breyer and Felder 2006). With rigorous analysis of recent healthcare data, we can therefore confirm what studies spanning earlier decades for British Columbia, elsewhere in Canada and other comparable health systems have found: the net impact of demographic factors on major components of the healthcare system is moderate (Denton and Spencer 1983; Fuchs 1984; Barer et al. 1987, 1995; Gerdtham 1993; Evans et al. 2001; McGrail et al. 2001). Moreover, when we forecasted the effects of expected demographic changes in British Columbia through 2036, we found that the future effects of population aging on healthcare spending will continue to be modest (1% or less per year).
  • Our findings also indicated that average payment per unit of hospital care increased over the period. The increase in hospital unit costs may have been an appropriate policy response to increases in age-adjusted clinical complexity per patient remaining in care following reductions in the average length of stay
  • After taking into account population aging, the average number of days of prescription drug therapy received by British Columbia residents grew more than 5% per year during the first half of our study period and plateaued in the latter half of the period (data not shown)
  • Despite popular claims about population aging and the sustainability of healthcare in Canada, demographic changes exert steady, predictable and modest forces on the cost of major components of our healthcare system. This is likely to remain true for the foreseeable future.
  • Irene Jansen on 23 Jan 12
     
    Despite popular claims about population aging and the sustainability of healthcare in Canada, demographic changes exert steady, predictable and modest forces on the cost of major components of our healthcare system. This is likely to remain true for the foreseeable future. Changes in the age-specific profile of healthcare costs, by contrast, can exert and have exerted significant pressures on health system costs. Clinicians, policy makers and patients have some discretion over the non-demographic sources of healthcare cost increases - unlike population aging. Though these results are largely confirmations of studies from past decades, it is nevertheless important to update the scientific basis for policy debates. Moreover, close attention to recent trends and cost drivers - such as the price of prescription drugs that drove pharmaceutical expenditures in the past decade - also helps to illuminate the non-demographic forces that seem most amenable to policy intervention. Ultimately, then, research of this nature is a reminder that the healthcare system is as sustainable as we want it to be.
Govind Rao

Economic inequality is bad for our health - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246471|tost|20150426|219226356

from heather determinants poverty

shared by Govind Rao on 28 Apr 15 - No Cached
  • Toronto Star Sun Apr 26 2015
  • The powerful relationship between poverty and health has been documented for nearly two centuries. We have long known that a person's economic position is the strongest predictor of their health status. Being poor means dying sooner and dying sicker. A Toronto Public Health report released earlier this week concludes that poverty is literally imprinting itself on the lives of Torontonians. The findings presented in the report are grim. Over the past decade, health inequalities between the rich and the poor have persisted. In some cases, they have grown wider. Opportunities to be healthy in Toronto remain as unequally distributed as ever. The report rightfully attributes these inequalities to the social determinants of health - a diverse range of factors including income, education, employment and housing.
  • We live in a divided city and the deepening of economic cleavages has become a defining feature of our civic landscape. Income inequality is on the rise. Housing is becoming less affordable. Neighbourhoods are becoming more polarized. And the cost of living has far outpaced individual earnings. In Toronto, as elsewhere, the social determinants of health have suffered significant decline. As the report makes clear, the poorest among our city's residents have borne the greatest part of this burden. These trends have affected the health of the poor in countless ways. They have constrained access to quality health care. They have increased susceptibility to harmful behaviours, such as smoking. They have compromised the adequacy and stability of housing conditions. They have restricted access to nutritious foods. They have heightened exposures to daily stress and adversity that get under our skin and harm not only our minds but our bodies as well. In fact, research has shown that economic conditions underlie almost every pathway leading to almost every health outcome.
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  • oronto has made little progress in the fight against poverty over the last decade and thus it's to be expected that health inequality remains stark. We find little fault in the actions of Toronto Public Health. Rather, as the science makes clear, the true guardians of our health are the policy-makers that determine whether all Torontonians - and all Canadians, more generally - are able to keep up with the costs of everyday life. What can we do? We can create widespread recognition that when our governments fail to redress inequalities, they undermine the health of our society. We can engage in civic and political action to help pass public policies that reduce the economic distance between the rich and the poor. We can also support organizations that advocate on behalf of these policies, including Toronto Public Health and the labour unions that protect the conditions of low-wage workers.
  • So it shouldn't come as a surprise that, despite a decade of public programs intended to promote health equity, the health status of the poorest Torontonians hasn't improved. In fact, this was entirely predictable. At the heart of the issue are two important insights provided by our best available science. First, public health programs that are designed to encourage people to alter their lifestyles and behaviours simply do not address the myriad other associations between economic position and health status. Attempts to address any one problem do little to fundamentally interrupt the overall correlation. Second, because public health programs do not address the "causes of the causes," they are incapable of stemming the tide of new individuals that develop poor health-related behaviours. No sooner has one cohort been exposed to a health-promotion program than another is ready and waiting.
  • Health inequalities are one of the most formidable public health problems of our time. The science strongly supports Toronto Public Health's insights that public health programs are wholly insufficient to alleviate their burden. The solution lies in tackling the unequal distribution of resources that has become a defining feature of our city and our society at large. Arjumand Siddiqi is assistant professor and Faraz Vahid Shahidi is a doctoral student at the Dalla Lana School of Public Health, University of Toronto. Correspondence should be sent to Ms. Siddiqi at: aa.siddiqi@utoronto.ca
Govind Rao

With The ACA Secure, It's Time To Focus On Social Determinants - 0 views

healthaffairs.org/...o-focus-on-social-determinants

from heather determinants us

shared by Govind Rao on 22 Jul 15 - No Cached
  • Social Determinants Elizabeth Bradley and Lauren Taylor July 21, 2015
  • Editor’s note: This article is part of a series of blog posts by leaders in health and health care who participated in Spotlight Health from June 25-28, the opening segment of the Aspen Ideas Festival. This year’s theme was Smart Solutions to the World’s Toughest Challenges. Stayed tuned for more. While Medicaid expansion remains a dream for Americans in many states, the integrity of both the state and federal marketplaces for insurance remained intact following the June 25 Supreme Court decision to allow the federal government to provide nationwide tax subsidies to help people buy health insurance. The following morning, Kathleen Sebelius led a discussion at the Aspen Ideas Festival calling the Court’s action “The strongest possible decision. Definitive.” The judicial victory provided space for participants to commit to asking new questions about how to improve health at a reasonable cost. After months of uncertainty, many of the leading minds in US health policy began to ask: What’s next?
Irene Jansen

The Standing Committee on Social Affairs, Science and Technology. Report on the progres... - 1 views

www.parl.gc.ca/...rep07mar12-e.htm

senate federal government accord

shared by Irene Jansen on 27 Mar 12 - No Cached
  • The Standing Senate Committee on Social Affairs, Science and Technology
Govind Rao

Guest Column: Value for health-care dollars in Canada › Medicine Hat News - 0 views

medicinehatnews.com/...-health-care-dollars-in-canada

from heather determinants US-Canada quality

shared by Govind Rao on 07 Feb 14 - No Cached
  • By Medicine Hat News Opinon on January 29, 2014.
  • Here’s a fact most Canadians probably don’t know: Canadians live longer than people in the United States.
  • This week we published a study in the American Journal of Public Health on the efficiency of healthcare systems at extending lives over the past two decades and it’s good news for Canadians.
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  • In our study, a country’s social investments contributed to significant increases in longevity.
  • social determinants
  • Poverty rates in Canada, while lower than the US, have been on the rise — and poverty is one of the leading determinants of poor health.
  • Jody Heymann is an expert advisor with EvidenceNetwork.ca and Dean of the UCLA Fielding School of Public Health. Prior to this, Heymann held a Canada Research Chair in Global Health and Social Policy at McGill University. Douglas Barthold is a doctoral candidate in economics, and a doctoral fellow at McGill University’s Institute for Health and Social Policy.
Govind Rao

Double whammy: Poverty can make you sick and cost you more, StatsCan study shows - Pres... - 0 views

www.digitaljournal.com/1855664

from heather determinants

shared by Govind Rao on 22 Apr 14 - No Cached
  • OTTAWA, April 16, 2014
  • The poorer you are the more it costs to stay healthy. That's the conclusion of a Statistics Canada study released Wednesday — and also validation of arguments that poverty is a health issue just as it is an economic one, the Canadian Medical Association (CMA) said. As a percentage of after-tax income, out-of-pocket spending on health care was greater in lower-income households, said the StatsCan study of prices between 1997 and 2009. In 2009, out-of-pocket spending on health care represented 5.7% of total after-tax income in households at the bottom of the income grid, compared with 2.6% at the top of the income scale. "This is further validation of what physicians have been saying for years — social determinants like housing, nutrition, education and even literacy have a direct bearing on your health,'' said Dr. Chris Simpson, President-elect of the Canadian Medical Association. ``This is why one out of every five dollars spent on the health care system can be attributed to social determinants.'' In a July 2013 report, the CMA urged the federal, provincial and territorial governments to elimination of poverty in Canada a top priority, and that guaranteed annual income be evaluated and tested through a major pilot project funded by Ottawa.
Doug Allan

A frightening time to be old | Toronto Star - 0 views

www.thestar.com/...rightening_time_to_be_old.html

LTC ALC

shared by Doug Allan on 10 Jun 14 - No Cached
  • On a weekly basis, once her condition was deemed “non-medical” and therefore no longer the hospital’s issue, I was pressured to put her into some alternative. Luckily I was able to take a compassionate care leave from work to investigate her options and research her rights (a kind CCAC worker suggesteed I call ACE).
  • Despite completing the applications for nursing home care, she still has a wait of potentially one year or more until a spot opens for her at one of the nursing homes we selected. Yes, there are others available sooner, but one look at Ministry reviews of some of those, and you wouldn’t put your goldfish in one. Lists of infractions are the deterrent.
  • He was in hospital for roughly three weeks, at which point, we were told by the discharge planner that Dad was “ready to come home”.
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  • Since March 19, 2014, when my 87-year-old father was admitted to hospital, we have been put through hell trying to arrange appropriate care for him.
  • As this was not feasible, given the fact that he could not safely navigate the stairs, we were told that we would have to put Dad into a retirement home in the “Wait at Home” program. We were instructed to find such a facility immediately and let them know, and to sign a consent for placement. At no time were we told that there were any other options available. We were told that the Wait at Home Program was for a period of up to 45 days, and that during that time, Dad would be assessed by CCAC for determination as to whether he was in crisis. CCAC agreed to put in place nursing care and personal support workers during Dad’s stay in the retirement home, up to a maximum of 21 hours per week, which under Dad’s circumstances was ludicrous.
  • We arranged for Dad to be admitted to a retirement home which cost $115/day, a fee we could not afford. The retirement home director sent a representative to the hospital to determine Dad’s needs and subsequently said they were “comfortable with the level of care required.” Within the two days there, Dad fell and hit his head. Dad told us this – the staff did not; however, they confirmed it when we asked about it. The personal support workers were “not allowed to feed Dad.”
  • Approximately 6 days into the program, Dad was returned to hospital from the retirement home with a urinary tract infection. The hospital emergency staff simply x-rayed, reinserted a catheter and sent Dad back to the retirement home at 3:00 a.m. by ambulance. Three days later, the retirement home again called an ambulance because Dad was not eating, and his oxygen levels were low. He was admitted to a Toronto hospital and was diagnosed with pneumonia.
  • The staff at the Toronto hospital advised that Dad had “so many acute issues” (pneumonia, Parkinsonism, Dementia) that a retirement home was neither equipped nor staffed to properly care for him. It was determined that not only could Dad not walk, but he could not even stand up without being assisted by two staff. My complaint is that at no time did the discharge planners / social workers during Dad’s first hospital stay advise us of any manageable options, we were railroaded by discharge staff to place Dad in a facility which was in no way equipped or staffed to care for him, and that was impossible for Dad to afford, and we were advised that placement into a long term care facility directly from hospital was impossible. We were not told about interim beds until after we had committed to place Dad in a retirement home.
Govind Rao

Costly probe opens over health workers - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246199|ntgm|20150916|229368227

from heather bc drug pharmacare investigation

shared by Govind Rao on 16 Sep 15 - No Cached
  • The Globe and Mail Wed Sep 16 2015
  • Armed with a start-up budget of $750,000, British Columbia's ombudsperson is launching what he expects will be a year-long investigation into the mass firing of Health Ministry workers in 2012. Jay Chalke said the budget, which will only cover the investigative work until the end of the fiscal year, will allow him to hire a team of nine investigators, who will begin by reviewing a massive cache of government records.
  • "It's a tremendously large amount of material," he said in an interview Tuesday. "The number of documents is in the six-figure range - and that is documents, not pages." The Office of the Ombudsperson was appointed this summer to investigate the dismissal of seven ministry workers and a contractor, all of them involved in pharmaceutical research. Mr. Chalke said he could not begin the investigation until details, including the scope and the budget, were approved by the legislature's finance committee.
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  • The government announced the firings at a news conference three years ago and maintained until recently that the RCMP were investigating the former workers for a serious breach of personal data. One of the researchers, Roderick MacIsaac, killed himself after being interrogated by government officials and fired just two days before the end of his student co-op term.
  • Premier Christy Clark and her ministers have since apologized for the firings and acknowledged the government had overreacted to a data breach involving patient information. However, an independent review by an outside lawyer could not determine who was responsible for the firings or why they occurred. The former workers, backed by the opposition New Democrats, have insisted that a public inquiry is required to determine the motivation for the firings and to identify the people responsible.
  • The Health Ministry staff and contractors were helping an independent agency called the Therapeutics Initiative to develop evaluations of the effectiveness and safety of prescription drugs. The information was used to determine if those pharmaceuticals should be eligible for coverage under the publicly funded PharmaCare program.
  • The government has consistently refused calls for a public inquiry, saying it would be an expensive and lengthy process. But it was clear on Tuesday that the ombudsperson's work will be neither cheap nor quick. Mr. Chalke said he expects to be back before the finance committee of the legislature next year to seek the funds needed to complete his review.
  • Mr. Chalke said he has been given wide latitude to investigate not only the firings, but the government's claims around the RCMP investigation, as well as the government's involvement with the pharmaceutical research organizations that were caught up in the affair. And he cautioned that the investigation could easily take more than a year. "My objective is to do a thorough investigation that gets to the bottom of this, rather than to shorten the investigation to meet some arbitrary timeline." Aside from Mr. MacIsaac, the other workers are Ramsay Hamdi, Robert Hart, Malcolm Maclure, Ron Mattson, David Scott, and Rebecca and William Warburton.
Govind Rao

Spreading holiday cheer by debunking health-care myths | rabble.ca - 1 views

rabble.ca/...er-debunking-health-care-myths

from heather determinants p3

shared by Govind Rao on 02 Jan 15 - No Cached
  • By Julie Devaney | December 23, 2014
  • So a decade and a half later, it is more than a little bit satisfying to see Ontario auditor general Bonnie Lysyk's report on Ontario spending. Public-private partnerships, which include building hospitals and other health-care infrastructure, have cost Ontario $8 billion more than publicly funded projects would have. The extra costs? Private financing and "borrowing costs." Lysyk says, unequivocally, "About $6.5 billion of this is due to higher private-sector financing costs." And perhaps this information will be lobbed back at you as simply about building hospitals with little relevance to health-care delivery. For this part of the argument, I direct you to Ontario's failing experiment with private health care in last month's column on private clinics.  
  • As Michael Rachlis points out, the costs to be worried about are not from medicare itself, but from increasing drug costs and other health services not offered within the public system. He argues that despite alarmist rhetoric, medicare costs remain stable and sustainable. Publicly delivered health care in publicly built hospitals is the most cost-effective option (not to mention the only way we can work toward a more equitable and just society).
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  • And if any of this gets especially heated and you're feeling especially cheeky, just whip out your smartphone and play Canadian doctor Danielle Martin's excellent deposition on medicare to the U.S. Senate.
  • In Canada, the top six determinants of health include income, social status, education, working conditions and physical and social environments. We don't need diet tips. We need guaranteed incomes and safe housing. We need social infrastructure that values people as people.
  • A team of doctors at St. Michael's hospital in Toronto have launched a project that approaches health this way. The team is finding that supporting people through concrete initiatives aimed at improving incomes and job security improves the health of their patients. And, I would argue, it does so far more effectively than the traditional methods employed by doctors who lecture us about lifestyle choices.
  • Julie Devaney is a health, patient and disability activist based in Toronto.
Cheryl Stadnichuk

Canada's sluggish track record on health inequality must be addressed, say experts &#82... - 0 views

ipolitics.ca/...-must-be-addressed-say-experts

inequality canada

shared by Cheryl Stadnichuk on 04 Apr 16 - No Cached
  • Cheryl Stadnichuk on 04 Apr 16
     
    Health inequality in Canada is growing. And nowhere is that more evident than in the health gap between indigenous and non-indigenous Canadians. In a report released last November the Canadian Institute for Health Information concluded that Canada wasn't likely to see any major improvements in health inequality without addressing the social determinants of health. "A big part of that isn't our health care system, it's that we don't have the kind of equal society, we don't have the social safety net that many European countries for example do. And that reflects in statistics," said Dr. Ryan Meili, a family doctor from Saskatoon and a former provincial NDP leadership candidate.
  • Cheryl Stadnichuk on 04 Apr 16
     
    Health inequality in Canada is growing. And nowhere is that more evident than in the health gap between indigenous and non-indigenous Canadians. In a report released last November the Canadian Institute for Health Information concluded that Canada wasn't likely to see any major improvements in health inequality without addressing the social determinants of health. "A big part of that isn't our health care system, it's that we don't have the kind of equal society, we don't have the social safety net that many European countries for example do. And that reflects in statistics," said Dr. Ryan Meili, a family doctor from Saskatoon and a former provincial NDP leadership candidate.
Govind Rao

Association between household food insecurity and annual health care costs - 0 views

www.cmaj.ca/...E429.full

from heather determinants food costs research cma

shared by Govind Rao on 14 Oct 15 - No Cached
  • CMAJ October 6, 2015 vol. 187 no. 14 First published August 10, 2015, doi: 10.1503/cmaj.150234
  • Our study showed that household food insecurity was a robust predictor of health care utilization and costs incurred by working-age adults, independent of other social determinants of health. Policy interventions at the provincial or federal level designed to reduce household food insecurity could offset considerable public expenditures in health care and improve overall health.
Irene Jansen

NB Coalition for Pay Equity holds forum - 1 views

www.evernote.com/...bd6dd973454102c2354c4d0506a28e

nb home care pay equity

shared by Irene Jansen on 23 May 12 - No Cached
  • Irene Jansen on 23 May 12
     
    After a number of years of lobbying by the Coalition and its partners, the Government of New Brunswick passed the Pay Equity Act in 2009, which applies to the provincial public service. Now, the Coalition is asking the government for a law that will cover the private sector. Last week, the government released the wages determined by the pay equity exercises initiated a few years ago. Eight job classifications were evaluated, but only two will obtain notable pay equity adjustments: child care support workers ($12.52 an hour following a $2.52 adjustments spread over five years) and home support workers ($13.15 an hour with a $2.15 increase spread over five years). "We are very surprised of the results .... they don't seem credible. We need full transparency"
Irene Jansen

CHSRF Oct 2011 What if: A sliding scale were used to reimburse generic drugs to effecti... - 0 views

www.chsrf.ca/...atIfASlidingScaleWereUsed.aspx

pharma drugs

shared by Irene Jansen on 23 Jan 12 - No Cached
  • Irene Jansen on 23 Jan 12
     
    Aidan Hollis, Department of Economics, University of Calgary Because generics offer no quality advantages over their branded counterparts, generic drugs compete for market share by offering low prices. The Ontario Drug Benefit (ODB) program, the largest drug plan in Canada, plays an important role in determining generic drug reimbursement prices. The ODB has set its generic drug reimbursement at 25% of the price of the reference branded drug. This has created unwanted consequences. In general, the price will be either too high or too low for any given drug, since this price-setting mechanism is arbitrary. If too high, payers are paying too much, and the excess profits will be divided between the pharmacies and the manufacturers. Excessive prices may also drive excessive
Irene Jansen

BCNU revisits 2009 numbers. Why? | Hospital Employees' Union Oct 20 2011 - 0 views

www.heu.org/...bcnu-revisits-2009-numbers-why

nursing bc

shared by Irene Jansen on 23 Jan 12 - No Cached
  • HEU's outreach indicates that most LPNs are sticking with HEU.
  • This lack of momentum may explain why BCNU has taken the bizarre measure of hiring a notary public to bolster its claim that it collected 3,000 cards during the failed 2009 raid.
  • It's a gimmick, of course. And not a very good one
  • ...2 more annotations...
  • Only the BC Labour Relations Board has the information – and the authority – to determine whether a card is really valid. And it took the LRB several months to verify the cards submitted by BCNU in 2009 to determine how many were valid.
  • That's why they're now picking and choosing the groups of LPNs that they will target in their raid.
Irene Jansen

International comparisons shed light on Canada's health system Nov 23 2011 CIHI - 0 views

www.cihi.ca/...RELEASE_23NOV11

international comparisons determinants

shared by Irene Jansen on 23 Jan 12 - No Cached
  • examines Canadians’ health status, non-medical determinants of health, quality of care and access to care. It is based on international results that appear in the OECD’s Health at a Glance 2011, also being released today, which provides the latest statistics and indicators for comparing health systems across 34 member countries.
  • While Canada has lower smoking rates than most OECD countries, rates of obesity and overweight are among the highest.
  • CIHI’s analysis shows that Canada performs relatively well in screening and survival rates for cancer
  • ...1 more annotation...
  • Canada is in or close to the top 25% of OECD countries on many measures of quality of care.
Irene Jansen

CBC.ca | White Coat, Black Art | Unfinished Business Show - 0 views

www.cbc.ca/...unfinished-business-show-1

care aide retirement homes regulation ltc ontario

shared by Irene Jansen on 23 Jan 12 - No Cached
  • we have reaction from Ontario's Minister of Health and Long Term Care to our season debut episode on personal support workers and the work they do at retirement homes in the Province of Ontario
  • personal support workers or PSWs, the subject of our full edition season debut episode back in September
  • unlike nursing homes, retirement homes operate in a regulatory grey zone.  And it's at these retirement homes where we found PSWs who say they're expected to perform duties they aren't qualified to do, like injecting insulin or administering narcotics.
  • ...4 more annotations...
  • We played some of Jen's interview to Deb Mathews, Ontario Minister of Health and Long Term Care. 
  • "That is a very troubling clip you just played for me," Mathews told WCBA.  "No health care worker should ever be put into a position where they feel that they're compromising the health and safety of their patients or their own personal safety."
  • As for the operators of retirement homes that compel PSWs to perform nursing duties that they may not be qualified to perform? "Well, I would say that they're taking a very big risk," she added.  "They really should not be supporting a practice that isn't safe."
  • But if retirement homes are taking a big risk, as the Minister puts it, it's a risk that exists in part because retirement homes aren't regulated nearly as strictly as long term care facilities.  And that won't be changing any time soon.  In terms of regulations, a retirement home is little different from your own home.  
  • Irene Jansen on 23 Jan 12
     
    The story on PSWs and interview with Deb Mathews runs from minute 1:34 to minute 9:28. Mathews: I would say to the operators "they are taking a very big risk and they really should not be supporting a practice that isn't safe - they have to take that responsibility very seriously" I'm asking PSWs to "please stand up and report this". The scope of practice for PSWs is not as clear as it ought to be ... this is why we're establishing the PSW registry. It will allow us to see the training and experience of PSW - this information will be available to the public. My expertise is long-term care homes. Very high standards there. Retirement homes in Ontario are different - wide range of people. They do not fall under the Ministry of Health. Dr. Goldman: Why not regulate retirement homes? Mathews: Because they serve a very different function - e.g. for people who are very healthy but would like to have for example their meals prepared for them. They are not health care facilities the way long term care homes are. A retirement home is a home. We really do want to offer choice to people. The retirement homes determine when a person needs care they can't provide. Dr. Goldman: Regulation of PSWs?  Mathews: I don't see it any time soon. We are working with our training colleges and universities on a common curriculum. Until we have that standard training and established scope of practice, we can't take them the next step to make them a regulated health care professional.
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