Determining the link between health and poverty

Poverty and Policy in Canada: Implications for health and quality of life
by Dennis Raphael
Toronto: Canadian Scholars’ Press, 2007

Reviewed by Maria Páez Victor

“If the misery of the poor be caused not by the laws of nature, but by our own institutions, great is our sin” –Charles Darwin

Anyone who is at all interested in the connection between health and poverty will find solid empirical evidence of this link in this book. Dennis Raphael writes masterfully about inequality and public policy in our country and how these affect the quality of life of our most vulnerable citizens.

Canadians have consistently demonstrated strong support for our universal, publicly administered, one-tier health care system. In comparison with that of the United States, which has the worst health care system of all the rich nations and has almost 50 million of its citizens without any medical coverage at all, there is ground for congratulations.

The comparison is anything but favourable however, when our system is contrasted to other rich nations. Canada’s health care and other important social services are less than what other European countries provide, especially policies towards reducing poverty. And Raphael readily demonstrates that inequality, the root of poverty, is the most prominent determinant of disease and illness, premature death, individual unhappiness and social unrest.

He also clearly indicates the social determinants of good health are the very same crucial elements in reducing poverty: adequate income and employment, access to education, support for family and social networks, and the quality of workplace and the natural environment. Poverty cannot be eradicated without serious consideration of social justice and equality.

Unfortunately, income and wealth inequalities in Canada have steadily increased while social assistance benefits and minimum wages not kept Canadians from poverty. Free-market ideology has led all levels of government to cut social assistance programs and crucial public policies that can directly diminish inequality. We should get all politicians to read this book.

Maria Páez Victor is a member of the CPJ Board of Directors and has taught and worked in the area of public policy.