The hierarchy of good health

A system that doesn’t deal with mounting strain can only collapse

Now that we are well into October, temperatures are rapidly starting to cool down and we are beginning to enter flu season in Canada.

Despite the availability of flu shots, it can be expected that many people will be impacted by this year's flu virus leading to an uptick in visits to their doctors. Unfortunately, for many people living in this region, this will not be possible as there is a chronic shortage of family doctors, a situation that has become increasingly more serious in recent years. If this doesn't change, the health outcomes for our population will decrease and, as with many things in our society, the impact will fall disproportionately on the poorest among us.

This is confirmed by a survey released earlier this month by the Newfoundland and Labrador Medical Association (NLMA). The poll, conducted on Sept. 17 by Narrative Research, revealed 19 per cent of residents in this

province – or about 99,000 people – do not have a family doctor. Digging more deeply, the results show that among families with an income less than $50,000, 26 per cent did not have a family doctor; as income rises, the percentage without a family doctor decreases and for families with an income above $100,000, only seven per cent lack a family doctor. While the results of the survey only apply to this province, I suspect similar trends are prevalent across the entire Atlantic region.

While there appears to be some recognition among our political leaders that a doctor shortage exists in this region, I am not convinced people realize just how critical the situation is and how close we are to a meltdown in our health-care system. For those with a lower income, it is much harder to travel around to find a family doctor when one becomes available. Therefore, many are forced to rely on emergency departments in hospitals. This puts a huge strain on resources that are already stretched to the maximum and does not provide for ongoing care people need.

When we add other factors faced by those with lower incomes, including food and nutrition insecurity, less adequate living conditions and challenges navigating the health-care system, we have a situation in which they face a much higher risk of chronic illnesses while at the same time facing a reduced ability to access the health care necessary to deal with these illnesses.

The inequality created in our health-care system is shocking for a country that claims to value that universal system. Despite claims of universality, the reality is the richer you are, the more likely you will be able to access appropriate care and have a lifestyle that allows you to prevent many health problems. Conversely, the poorer you are, the lesser the likelihood of being able to prevent health problems while at the same time having a harder time accessing health care in the first place. Such a situation can only increase the strain on our health-care system and any system under constant strain will eventually burst.

If you are one of the lucky Atlantic Canadians who has a good income and a family doctor, you need to be aware that this is your problem as well. For all of the provinces in this region, the largest single expense in our budgets is health care and the costs continue to rise every year.

This means we will continue to pay more in order to maintain our health-care system and the most efficient way to rein in these increasing costs is to prevent the frequency of which we need to access health services.

The most critical element in disease prevention is access to a family doctor in order to monitor health, provide appropriate care and intervene before health conditions progress to the point of requiring often expensive treatment. Right now, the greatest need for family doctors is among those in our society with lower incomes. Everyone has a right to a family doctor and any system that claims to be universal also needs to be accessible, especially for those who need it most.

Brian Hodder is an LGBTQ2 activist and works in the eld of mental health and addictions. He can be reached at bdhodder@hotmail.com.