How how do you maximize health for the greatest number of people? That’s the question British Columbia author Andrew MacLeod asks in his latest book — and his answers don’t have to do with the health-care system at all.
In All Together Healthy: A Canadian Wellness Revolution, MacLeod suggests that instead of investing in the health-care system, Canada should turn its attention to investing in the things that have been shown to have the greatest impacts on long-term health, like income supports, housing, and education.
“There’s always pressure to spend more on the health-care system; we already spend 11 per cent domestic income on it,” he said.
MacLeod said that, instead, we should put our money into solving economic and environmental inequality, which has the greatest impact on health outcomes.
“If everyone was as healthy as the richest 20 per cent of Canadians, there would be 40 per cent fewer deaths per year,” said MacLeod. He gave the example of diabetes, which has consistently has a higher incidence rate in populations with lower incomes.
In the course of his research, it became clear to MacLeod that a lifetime of good health starts in childhood, in the first five to seven years of life. If children have access to things like better food, housing and education, then they will have better health throughout their lifetimes, he said.
“For every dollar you spend in early childhood, you save seven dollars later,” he said. “It’s about setting conditions for better health in childhood and for families, otherwise you spend money dealing with the poor outcomes.”
Child tax benefits, which provide funding based on income, and progressive taxation on families are just some of the policies that can help lower-income families and in turn the overall health of children. But better policies could be put into place to create better health outcomes for children in care, he said.
“We have a system where kids growing up in care are five times more likely to die early,” he said, referring to a recent report by the Coroners Service of British Columbia. “We will take them into care even if we know the outcomes aren’t good there”
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