why being canadian makes us sick

today was the annual general meeting of the canadian mental health association. our speaker was dr. paul kershaw.  from his intro:

kershaw is an academic, public speaker and media contributor. he is one of canada’s leading thinkers about care-giving and family policy, receiving two national prizes from the canadian political science association for his research.

dubbed by some an ‘evangelist professor’, kershaw uses research to be a cheer-leader and critic of canadians with the intention of inspiring substantial policy change across the country. to this end, kershaw devotes time to liaise with leaders in government, the business community, the not-for-profit sector, and the academy.

kershaw does not shy away from tough issues. on radio he has been labeled a “boomer-hater” because he speaks about intergenerational inequities between baby boomers and the generations that follow. as a proud feminist, he chides the personal and policy decisions by which many men evade their fair share of care-giving work, and fail to enjoy a fair share of the joys that come with caring. among the general public, he argues that ‘being canadian’ is making us sick, because the medical system in which we take national pride shows more of a disease fetish than an aspiration to promote health. at the university of british columbia, in the college for interdisciplinary studies, kershaw is the human early learning partnership (HELP) scholar of social care, citizenship and the determinants of health.

here are my notes from his talk:

how many children come to school ready to learn? 70%. that sounds like a good number. but what if you turn it around?

30% of children come to our schools vulnerable (don’t meet age appropriate benchmarks – e.g. not fully developed re fine and gross motor skills, playing with peers, following simple instructions, etc.)

why should that worry us?

we are most sensitive to our environments in the early years. what happens in the early years sets the tone for the rest of the life.

statistically speaking, those who are vulnerable in kindergarten tend to have more problems with teenage diabetes, mental health, coronary heart disease, elevated blood pressure, premature aging, etc.

what are the fundamental failings in canada when it comes to looking after our youngest citizens?

poverty.

poverty 1: families are strapped for time – “i’ll compromise my time in the domestic area” work-life conflict – BC has the highest rate of work life tension
poverty 2 – service poverty (lack of social services)
poverty 3 – income poverty – we have the highest rates of poverty among children

5 reasons why we fail our next generations

1 – our perceptions don’t reflect reality
2 – lack of gender equality
3 – we have other policy priorities
4 – we have a disease fetish
5 – we are a boomer centric society

1 – misperceptions

  • canadian perceptions of reality are not reflective of actual reality
  • “do you knw what share of kids reach our school system vulnerable?” 82% of BCers underestimate how vulnerable we are
  • 86% thought we’re more generous to address these problems than we are

2 – lack of gender equality

  • we are at the bottom of OECD countries re family policy and gender equality
  • gender equality and family policy go together
  • we used to be #13, now #30
  • in 2001 we had a ministry for women’s quality, now we have no ministerial representation whatsoever
  • quebec is the only place with a good family policy because they want to breed more quebecois

3 – we have other priorities

  • 45% of our budget allocated to things medical
  • social service spending has contracted
  • health care is consuming an ever growing share of the budget, mostly because the budget overall has shrunk
  • social service spending used to be 18%, then 15% just before recession, now even less – 500 dollar less per person now

4 – we have a disease fetish

  • a mismatch between how we devote our public spending and how we spend on children
  • spending increases as we get older despite the fact that it would have the most impact if it was spent on children
  • this reflects that when someone gets sick we want to be there
  • we are lousy at prevention
  • but what do we owe ourselves in this society?
  • another example: we spend millions to save the lives of preterm babies but spend nothing on things like food for 5-year-olds
  • do we want to be dominated by disease or by health?

5 – we are baby boomer centric

  • this creates intergenerational tensions
  • politicians are baby boomers, they want to spend money on what concerns their age group
  • we can tackle children’s problems in a 5-year period (different from, say, environment, which takes much longer)
  • but baby boomers are aging so that’s what they pay attention to
  • we are also worried about pensions. but we are doing well with pensions and we’re not ranking well at all when it comes to children.

what do we need to do?

  • we need to think about health promotion differently. we need to address time, service and income poverty. improve parental leave system. why 40-45 hours a week for both parents? typical canadian works 300 more hours than the typical dutch person; netherlands and scandinavians do much more for children
  • need to increase welfare by 50%, and need to think about tax policies for the working poor
  • service poverty – need access to monthly parenting support and health check in. too spotty right now.
  • after kids are 18 months, needearly learning and care services. THAT is a major health promotion policy.

this is not inexpensive, a good 3 billion dollars a year. where to find the money?

1 – we HAVE found an extra bunch of money before, for increased health services
2 – if you’re patient, prevention early on has HUGE economic payback once they hit the labour market. we can predict the quality of our labour supply. with increased child health, we can increase economic growth by 25% – enough to pay down entire debt before these kids reach retirement

4 thoughts on “why being canadian makes us sick

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  2. Evan

    I don’t know about Canada, I’m an Australian.

    However 3 billion is chicken feed – maybe a dozen jumbo jets. How many planes for killing people? How many subs? It really is a matter of priorities.

    And my understanding is that money spent on childhood stuff saves expenditure later. By a factor of 7 according to some. (Which shows that those who claim to be hard headed economic rationalists – politicians and such – aren’t. If the expenditure was rational our expenditure on childhood stuff would be hugely higher than it currently is.)

    Anyway, end of rant.

  3. isabella mori

    rationality and economics is typically of little interest to politicians; they just pull that card when it’s convenient (and then they often use rationalizations instead of rationality).

  4. Aurelia

    I agree and I disagree….I always hate the idea that we have to choose between people or items because it sets up a competition and pits us against each other.

    I also think that so much of our system is based not on disease treatment, but on judging and punishing others. We don’t pay for mental health treatment, smoking cessation, or addiction treatment and then we are shocked so many people smoke as a form of self-medication, can’t quit and get emphysema and heart disease and cancer and we won’t treat them because it’s futile and end of life and “they deserved it”.

    Except we set them up to fail because we made a moral judgement instead of a health decision.

    Same for things like spending millions treating premature babies and none on feeding 5 year olds. Again a false comparison. In both cases, the root causes are the health and welfare of the parents. Educated, healthy parents who have lots of good food, safe secure shelter, and supportive community in the 12 months prior to conception have a mind-boggling dramatically lower rate of premature birth.

    And a much lower chance of being unable to feed the 5 year old later on. In fact, the single biggest lifetime determinant of health in any human being is preconception health of the mother and father and prenatal health of the mother. Literally, it’s all catch up after that.

    So why not provide birth control, sex ed, abortion, higher education, job opportunities, and preconception and prenatal care to all? Why not provide people with carrots and not sticks? Why not make it easy and simple?

    Because in the end, we aren’t interested in saving lives, we only care about judging and crapping on others. We keep the poor and the desperate fighting each other instead of those with power.

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