What the Greene report misses

This is no time to sit on the sidelines and let others do the work. The problem is too big for government alone to resolve.

In her report, Dame Moya Greene states that Newfoundland and Labrador has “a strong, resilient population with a deep love for this province.” Many people will see this as a platitude but it is actually one of the most important assets that we have. The fact that people care very deeply about this province means that they may be motivated to take action to help resolve the situation in which we find ourselves.

Almost 40 per cent of the provincial budget goes to health care, and a large portion of this goes to primary health care delivered in hospitals, clinics and doctors’ offices. Despite this massive investment, the province ranks the worst in Canada when it comes to chronic diseases, such as cardiovascular disease and diabetes, as well as cancers, many of which have environmental causes. It is estimated that two-thirds of all these illnesses are preventable.

As a society, we smoke too much, drink too much alcohol, eat the wrong foods and don’t exercise enough. In many cases, we do these things to deal with the stresses of daily life: getting and keeping a steady job, keeping a roof over our heads, getting enough food to eat, dealing with childhood trauma, dealing with domestic violence, etc. Years and even decades of these stresses cause somatic changes in the body, leading to chronic illnesses.

So, if we want to divert people away from our health-care system, we need to go upstream and address the issues that cause people to become ill. The theoretical model for this is the “determinants of health”: a stable job, a high level of education, a feeling of belonging to society, a healthy environment, physical activity, etc.

This requires a wholeof-society approach, which means getting volunteers involved. If we want to resolve deep, systemic problems, we need to get as many volunteers involved as possible. We need to create housing co-ops, food security networks, after-school programs, recreational activities that get people moving and that bring neighbours together, cultural groups, environmental organizations and similar groups.

Fortunately, there are lots of potential volunteers available. We have the oldest population in the country, which means that we have lots of retirees with time on their hands.

This is no time to sit on the sidelines and let others do the work. The problem is too big for government alone to resolve. Each and every one of us, through action or inaction, is responsible for the situation we are in, and it will take the efforts of all of us to get us out.

However, government can and must play an active role in helping to organize the efforts of volunteers. We need to create more not-for-profit organizations to address social issues that cost us money in the long run. And we need to staff these organizations with volunteers who will work directly with those in need. Fortunately, Memorial University has one of the very few centres for social enterprise in the country that could help with this task.

In one important area, the Greene report misses the mark. We are not going to get out of our situation simply by cutting public funds. All that will do will is make life even more difficult for the more vulnerable among us, who will turn even more to the health-care system for help. What we need to do is invest in areas that will reduce our health-care costs in the future.

This investment needs to be long-term but it will eventually bear fruit. At that point, we will be able to reduce the largest and fastestgrowing element of our provincial expenditures: the health-care budget. Michael Clair St. John’s