Politician ignoring links between politics and health
The primary causes of health, disease and premature death are the living and working conditions Canadians experience. We’ve known this since the mid-1850s and any visitor to the Public Health Agency of Canada’s website will find ample documentation of this fact.
Indeed, a recent statistics Canada report found that 40,000 Canadians a year die prematurely because their working and living conditions are not of the quality experienced by well-off Canadians. Gaps in income and wealth kill.
These living and working conditions are shaped by public policies made by Canadian governments at all levels. These policies serve to distribute economic and social resources among the population. This is why political scientist Harold Lasswell defines politics as Who Gets What, When, How.
Evidence is clear that over the past three decades these public policies have increased income and wealth gaps among Canadians, led to stagnating incomes for 60 per cent of Canadians, and created an explosive increase in insecure and precarious employment, all of which contribute to disease and illness. Most strikingly, Canadian children fall well behind most developed countries on numerous indices of health and well-being according to UNICEF Canada.
Yet despite the strong link between living and working conditions and health and disease, evidence these living and working conditions are not improving for most Canadians and in fact declining for many, the issue of what has come to be called the social determinants of health has not made it onto any public policy agenda at any level of government in Canada.
Not surprisingly, most Canadians mistakenly believe achieving health and avoiding disease and premature death will be achieved by adopting so-called “healthy behaviours” such as refraining from tobacco and excessive alcohol use, exercising, and eating more fruits and vegetables. The inaccuracy of these claims has been demonstrated over and over again in numerous studies in Canada and elsewhere.
Why are politicians unwilling to go near the politics and health and disease issue? Is it because they believe that Canadians are incapable of understanding this relationship? Such a belief would not be unreasonable as Canadians are bombarded by government, disease association, and media messaging that all that is necessary for health is to live a so-called healthy lifestyle. This serves a variety of purposes. It allows government to avoid dealing with issues of deteriorating living and working conditions, it provides an easy fundraising tool for disease associations, sells newspapers, and avoids the wrath of corporate Canada who many see as responsible for these deteriorating living and working conditions.
In the midst of all of this gloom and doom, hope is on the horizon. In Saskatchewan a single voice has consistently spoken of the relationship between politics and health. Family doctor Ryan Meili has taken on what should be the easy task of arguing that the goal of all public policy is creating conditions for health. He wrote an accessible book entitled A Healthy Society that provides a rationale for this approach and founded the national organization Upstream whose goal is promoting governance for health.
Taking seriously the relationship between politics, public policy, and health, Meili entered the political realm and now sits in the Saskatchewan legislature. Research shows most Canadians implicitly recognize their living and working conditions shape their health. The problem is that unless they enrol in university courses on the sociology and political economy of health they do not hear about this.
In Saskatchewan at least, this should now change. Perhaps this second coming of Tommy Douglas will lead Canadians to stop blaming themselves for their diseases and poor health and instead demand governments create public policies that promote — rather than threaten — health.