Canada may be a wealthy country but 9 per cent of people are poor and doctors say that's bad for their health.
Photo Credit: CBC

Poverty undermines health say doctors

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“Poverty is one of the most important determinants of health, perhaps the most powerful determinant of health,” says Gary Bloch, a family physician at St. Michael’s Hospital in Toronto.  9 per cent of Canadians have low incomes according to government statistics. The Canadian Medical Association which represents doctors is asking people across the country how poverty affects their health.

Bloch sees the answer in his practice every day. “People who live in poverty show health impacts throughout their bodies,” he says, “from higher levels of heart disease, kidney disease, of diabetes, of cancer. Poverty affects children especially hard.”

Effects on children in poor parts of Canada’s largest city, Toronto, resemble those of children in developing countries, says Bloch. “(They suffer) things like significantly higher rates of infant mortality in Toronto’s poorest neighbourhoods, higher rates of children born to low birth weights.

“These are the things that really concern me as a physician and as a citizen, but certainly things that raise poverty on my radar and make me push it way up my priority list when I’m trying to figure out how to deal with my patient’s health situation.”

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Dr. Bloch is teaching medical residents how to weave in questions about income when taking a patient’s history. © CBC

Income is doctor’s first question

Income is the first thing Bloch asks his patients about and, if they are poor, he spends a good amount of time helping them find ways to boost their revenue whether it’s through various government assistance programs, subsidized housing, paying lower taxes  or even advice on getting a job. He thinks it is the most important thing he can do to improve their health.

How poverty affects health is complex. Not being able to eat properly or to exercise affect health. Although Canada has universal, publicly funded health care, the poor often don’t have family doctors and they live will a lot of stress.

People who don’t know how to pay their rent or groceries are under constant stress, says Bloch, and that is a major factor in overall health.

Governments should modify and step up their efforts to mitigate poverty, he thinks. He notes that Canada has a guaranteed income supplement for needy senior citizens. He would like to see something similar for other poor Canadians. That, he is sure, would greatly improve their health.

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