25 in 5: Breakout Group on HealthWellBeingSocial Inclusion What Kinds of Measures Would Show Progres

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25 in 5 Breakout Group on Health/Well-Being/Soci
al Inclusion What Kinds of Measures Would Show
Progress in Reducing Poverty? Monday, January
28, 2008 Lynn Anne MulrooneyRegistered Nurses
Association of Ontario
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Social determinants of health

• early childhood development
• education
• employment and working conditions
• food security
• health care services
• housing

• income and its distribution
• social exclusion
• social safety nets
• Unemployment
• Women, Aboriginal people, Canadians of colour,
  and new Canadianssystemic structural
  inequalities
• Toronto Charter for a Healthy Canada

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Why Poverty Matters

• Life expectancy at birth (2005)
• Japan 82.3 years
• Zambia 40.5 years HDR 2007-2008
• Early life experiences have a life-long impact
  on brain and body development. Children living
  in poverty are at greater risk for poorer mental
  and physical health throughout life. Keating
  Hertzman, 1999

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Death and Social Gradient
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Unexplained Risk of Social Gradient
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Resources

• Raphael, Dennis (2007). Poverty and Policy in
  Canada Implications for Health and Quality of
  Life. Toronto Canadian Scholars Press.
• Marmot, Michael (2004). The Status Syndrome How
  Social Standing Affects our Health and Longevity.
  New York Henry Holt Co.

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Political Regimes Health Outcomes

• Health is a measure of the degree to which the
  society delivers a good life to its citizens.
  Sir Michael Marmot, WHO Commission on SDOH
• Political traditions that were more egalitarian
  implemented redistribution policies had less
  poverty, less income inequality, lower infant
  mortality, higher life expectancy.
• (Navarro Shi 2001 Navarro et al. 2006)

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Definitions

• Life expectancy number of years a person would
  be expected to live, starting at birth
• Infant mortality incidence of newborns dying
  during first year of life (per 1,000 live births)

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Changes over time

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Life expectancy in Canada
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Life Expectancy, Males, Canada 1996
Yrs
Source Wilkins et al., 2002, Health Reports
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Life Expectancy, Females, Canada, 1996
Yrs
Source Wilkins et al., 2002, Health Reports
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Infant Mortality
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Infant Mortality, 1996
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Questions

• Within this sector, what do we want a poverty
  reduction strategy to change?
• How can we measure whether that change is
  happening?

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Questions

• How can we ensure that the changes and measures
  or indicators benefit marginalized groups,
  specifically
• Racialized groups
• Women
• Person with disabilities
• Aboriginal people
• Newcomers
• children