Tackle poverty to cut health bill

Posted on June 13, 2013 in Health Policy Context

ThesStarPhoenix.com – business
June 13, 2013.   By Mark Lemstra

Imagine living in a country where your government not only prioritizes tax dollars to improve the health and well-being of your children today, but invests your money to reduce social problems and costs down the road as well.

That is the challenge put forth by UNICEF’s latest report, released in April, which advocates that governments have a moral imperative to ensure the well-being of children. UNICEF also reviews the evidence and concludes that the lack of government action results in impaired cognitive development and reduced skills, lower earnings, higher unemployment, increased dependence on welfare, more crime, greater likelihood of drug and alcohol abuse, more teenage pregnancies, higher incidence of mental illness and increased health-care costs.

The UN agency conducted an international comparison to determine the well-being of children in 29 mostly affluent countries in Europe and North America. When objective criteria were reviewed, Canada scored 17th out of 29. However, when child self-report outcomes were included, Canada dropped to 24th.

Our politicians should be thankful that the overall analysis did not include Japan, Australia, New Zealand, South Korea and so on. When data were available for these countries, Canada fared even worse in comparison. As well, most of the data collected from Canada do not include First Nations children living on reserves, where various governments have allowed children to live in deprivation.

Among sub-categories, Canada’s worst performance by far was in child health outcomes and the performance of the health system, where it ranked 27 out of 29. Canada scored higher than only Latvia and Romania, but below countries such as Slovenia, Slovakia, Estonia and Lithuania.

For example, in the category of infant mortality, Canada ranked 22nd, with a rate double that of Slovenia. As a city, Saskatoon scored much worse than the Canadian average. For health system performance in categories such as child immunization rates, Canada was 28th out of 29. While lower-income countries such Hungary and Greece are able to obtain a child immunization rate of 99 per cent, Canada struggles. Saskatoon fares much worse than the Canadian mean.

In the sub-category of education, Canada ranked 14th, but some explanation is required. In the area of participation in education, we score poorly, ranking at 24th.

Unlike in other jurisdictions, our federal and provincial governments do not prioritize children attending and completing school. However, in the area of quality of education provided, Canada ranks second among the 29.

When governments get children in school, our teachers do a fantastic job in a number of areas such as reading, math, and science literacy. UNICEF attributes leader Finland’s success to spending considerably more on education, requiring high minimum qualifications for educators and low teacher-to-staff ratios. For example, kindergarten classes have a ratio of one teacher to seven students. Compare that to your child’s classroom.

Other than quality of education delivered, there is no other area in which Canada shines. Most of the UNICEF report is filled with bad news.

For example, Canada ranks 27th among 29 in child obesity, last in drug use, and 22nd in youth homicide rates. For children’s self-reports of their life satisfaction, we rank 24th.

Although Canada ranks 21st on child poverty, it fares much better in regards to child poverty gaps. In plain language, we have many children who live in poverty, but it would not cost much to lift them out of deprivation. “Child poverty is not inevitable but policy-susceptible, and some countries are doing much better than others at protecting their most vulnerable children,” UNICEF says.

Overall GDP growth isn’t the key. UNICEF concludes, “There is not a strong relationship between per capita growth and overall child wellbeing. For instance, Slovenia ranks higher than Canada.”

The specific answer is to lift individual children out of poverty. This is something that eludes Canada as a nation and Saskatchewan as a province. Where do we start?

UNICEF Canada president David Morley concludes that we haven’t invested as much in public education as other countries. To help specific children in need, we will need targeted, inter-agency and multi-disciplinary interventions based on evidence.

Not only will this improve child well-being today, but it also will lead to better outcomes and reduce costs in the future.

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