Canada’s failing grade for poverty and inequality is bad news for health

By Dr. Trevor Hancock*

It is no surprise to we who work in population and public health that Canada in general and BC in particular has a poor record when it comes to poverty and inequality. And we understand only too well – and see on a regular basis – that poverty not only sucks but that it also sickens, depresses, injures, maims and kills. We also have seen that inequality in a community can be corrosive, widening the gap between the advantaged and the disadvantaged to the point that a sense of community is lost – as French philosopher Raymond Aron put it, “when inequality becomes too great, the idea of community becomes impossible”.

BC in particular has gained an unenviable reputation as the capital of child poverty in Canada and organisations such as the PHABC and the Health Officers Council have been vocal in calling for action to reduce child poverty and improve health. In doing so, we have joined with the ‘usual suspects’ – our colleagues and partners in the social development world, those working for a more just society and so on. But it is heartening and comforting to see that people in the business world also see these issues and understand their importance.

Which brings me to the “Society” report released this week from the Conference Board of Canada on Canada’s performance as a society. For those not familiar with the Conference Board, it is an independent, non-partisan, not-for-profit applied research organization catering largely to Canada’s business community and to governments. They have for some years been exploring the issue of population health and the social determinants of health, and they recognize both the implications of this issue for business and the role that business can play in addressing the social determinants of health. Now, the Conference Board has examined Canada’s progress in “providing a high and sustainable quality of life for all Canadians”. In their report they point to Canada’s poor performance on poverty in the working age population, child poverty, income inequality and gender equity as “troubling for a wealthy country”.

The Conference Board notes that the goal that it sets out for Canada (as noted above) “requires much more than economic success. By ‘high quality of life,’ we mean communities that:

  • ensure the active participation of individuals within society, including its most vulnerable citizens (such as youth and people with disabilities)
  • minimize the extremes of inequality between its poorest and richest citizens
  • are free from fear of social unrest and violence.”

Using OECD data, the Conference Board finds that Canada rates a ‘B’ overall for its social performance and comes 7th out of 17 countries examined, trailing the Nordic countries, the Netherlands and Austria, but ahead of countries such as the UK, Australia, Japan and the USA – which comes dead last. Canada has had a B grade throughout the last two decades, which the Board notes “means it is not living up to its reputation or its potential”.

The Board measures social performance “using 17 indicators across three dimensions: Self-sufficiency, equity and social cohesion”; it is particularly in the area of equity that Canada performs so poorly. Specifically, Canada gets a ‘D’ grade for its rate of working age poverty (“the working-age poverty rate rose from 9.4 per cent to 11.1 per cent” between the mid-1990s and the late 2000s) and a ‘C’ for child poverty (“the child poverty rate increased from 12.8 per cent to 15.1 per cent”), the gender income gap and income inequality. Only in elderly poverty did Canada get an ‘A’, but even here “The elderly poverty rate increased from 2.9 per cent to 6.7 per cent” in that same time period.

Noting that the rising rate of child poverty is “particularly disappointing”, the Board quotes the OECD as follows:

“Failure to tackle the poverty and exclusion facing millions of families and their children is not only socially reprehensible, but it will also weigh heavily on countries’ capacity to sustain economic growth in years to come.”

All this leads the Conference Board to conclude that “The self-image of Canada as kinder and gentler is based largely on a narrow Canada–U.S. comparison”. . . .  and that self-satisfaction is,

“not justified when Canada’s social performance is compared with its peer countries. Six countries rank above Canada overall, and Canada’s “D” grade on working-age poverty and “C” grades on child poverty and income inequality, are troubling for a wealthy country.”

Turning finally to BC, it used to be that BC had a mechanism for doing its own reports on performance. But the Progress Board, established by Premier Gordon Campbell, was later abolished by him shortly after it had the temerity to point out BC’s poor performance on many of the same social development measures as those used by the Conference Board. But given that BC has had the highest rate of child poverty in Canada for much of the past decade, and that until very recently its minimum wage had not increased for a decade, slipping from the highest to one of the lowest rates in the country, it is safe to assume that BC trails Canada in the areas highlighted as problematic by the Conference Board, with predictable, harmful and expensive consequences for health.

 * Dr. Trevor Hancock is a Professor and Senior Scholar in the School of Public Health and Social Policy at the University of Victoria