By Ted Bruce
Tuesday’s provincial Speech from the Throne sets out a vision for revenue generation for the future, relying heavily on the natural resources of the Province. But is falls very short of a vision for the health of British Columbians. There is an understandable concern with the economy and the deficit and debt of the Province. However, it fails to recognize that a central and ever increasing pressure on government finances is the cost of health care, which now eats up close to 50% of the provincial budget. It seems we have become addicted to finding money to pay for the demand for health care interventions without taking on the long term challenge of moderating the growth in expenditures by creating a sustainable health system founded on prevention.
Tuesday’s Speech from the Throne is another missed opportunity.
What could have been said if a prevention lens was applied to the Government’s intentions?
There was considerable emphasis on jobs especially in the construction and trades. This demands an increase in injury prevention. Does public health have the capacity to deal with the type of industrial growth envisioned in the Speech? We are making improvements in tackling injuries, but injuries especially among young people are a major contributor to hospitalizations and health care use. Investments in injury prevention are needed – and they pay off.
The Speech highlights how BC is a new home and refuge for many people seeking opportunity in a new country. And yet there is little recognition that many new Canadians come to this province healthier than many Canadians. Unfortunately they lose some of this benefit as they adopt unhealthy lifestyles promoted by the relentless advertising machine of the junk food industry. This is an added problem for new Canadians; for many their income situation also has long term consequences for their health, and especially that of their children. We know many immigrants experience income insecurity while working for minimum wage and struggling to find child care so they can enter the workforce. The socioeconomic inequity they experience compared to other Canadians puts them at risk for health problems. How can we protect the healthy immigrant effect? We need to strengthen public health’s effort to promote healthy living and put in place and enforce regulatory measures to protect the health of the public, especially that of children. That is a prevention agenda for new Canadian families. And we need to ensure a strong social safety net for all Canadians that will mitigate and reduce socioeconomic inequities.
Progress is being made on preventable deaths and the Speech mentions cancer prevention. The case of cancer prevention is an informative one. It demonstrates we can, through prevention, make huge strides in reducing death and illness. But groups such as the Canadian Cancer Society BC and Yukon Division who, along with PHABC and a number of other health organizations initiated the BC Healthy Living Alliance, have documented some of the additional resources needed in the prevention area for some key chronic diseases. This represents a vision for the future. Unfortunately, the Speech from the Throne simply makes minor reference to what is one of the greatest public health achievements in history rather than setting us on a path to a healthier future based on investments in prevention.
The Speech from the Throne recognizes the important role of early childhood education and child care, stating that there will be new initiatives in these areas. That is good news for public health because we know these investments are foundational to the long term health of young people and families. But we also know that piecemeal approaches are not particularly effective. We have learned this from public health experiences such as tobacco reduction where a comprehensive approach was required, involving a range of strategies including health education, regulation and pricing. The reduction of health inequities requires no less of a comprehensive effort. Rather than small incremental changes in early childhood and child care, a full health inequity strategy is needed, one that includes initiatives aimed at income security, food security, early childhood supports and affordable housing. Almost every other province in Canada has recognized this in adopting comprehensive poverty reduction strategies, and it requires a bold vision and political will to move forward in BC.
From a health perspective, it is a vision for the future that seems to be missing in this Speech from the Throne.
– Ted Bruce is the past-president of the Public Health Association of BC
Further reading:
2013 Speech from the Throne | BC Government | February 12, 2013
Throne Speech childcare pledges too vague, advocacy groups say | The Globe and Mail, February 13 2013