Torch 2018 Autumn.qxp_Torch 2018-10-29 4:04 PM Page 22
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A Healthy Debate English alumnus and journalist Andrew MacLeod (BA ’96) spoke to Stephanie Harrington (MFA ’17) about his new book, All Together Healthy: A Canadian Wellness Revolution (Douglas & McIntyre).
Canadians, media and health experts have variously described our health care system as broken, the worst in the world, or a point of national pride. Your book takes a wider view, arguing that good health does not exist in isolation. What inspired you to write All Together Healthy: A Canadian Wellness Revolution? When we talk about “health” in Canada, most people immediately think about the health care system, the doctors, nurses, hospitals and drugs, which we already spend a large amount of public money on and that are mainly useful after people are already sick. In doing so we overlook the evidence that other factors—including a person’s income, education, employment, working conditions, food security, housing and social connections—have a huge bearing on how healthy they are likely to be. My hope was to shift the discussion to encourage seizing the opportunity to do more of the things outside of the health-care system that would help more people stay healthier longer. You write that social inequity manifests in health inequities: “But the public discussion tends to ignore that many of the prime determinants of a person’s health lie outside of the individual’s immediate control.” Why have governments ignored their own reports, which date back to the 1970s, on health care? There are many answers to that, most of which have to do with competing priorities. Whether it’s producers of junk food, sellers of cigarettes or makers of pharmaceuticals, for example, lots of people profit from things being the way they now are. At the same time, there’s much more public pressure on politicians to build new hospitals or fund more MRIs than there is to deal with child poverty, even though there’s very strong evidence that the conditions of a person’s childhood directly affects how healthy they are likely to be later in life. For the public, it means shifting our perspective so that we’re asking politicians to make evidence-based decisions that will
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maximize the health of the maximum number of people. You argue governments don’t need to spend more to improve the health of Canadians, but they do need to spend better. What will happen if governments do not heed this advice? As a country we spend as much or more than most of our peers on health-care services, and yet we get no better results. Where we fall short is in the spending on other social services that are proven to have a significant impact on people’s health. If we keep doing what we’re doing, we’ll see both social and health gaps continue to grow and we’ll all suffer the consequences together in the form of tent cities, the overdose crisis and many other outcomes it would be best for all of us to avoid. It would be a huge missed opportunity. What are the most critical areas then for governments to address? All Together Healthy, Andrew MacLeod’s new book (Douglas & McIntyre).
It starts with taking a “health in all policies” approach where every decision is assessed in terms of what it will mean to people’s health. If we did that, one of the first things that would change would be the way we support families and other people who are raising children. More generally, dealing with deep poverty and doing more to address unmet housing needs would go a long way to making us a healthier country. What do you hope this book achieves? My hope is to widen our public discussion on what contributes to health. We need to recognize how health inequities are tied to social inequities, then act on that knowledge and do more to support families to be healthy so that they can raise healthy children. Many of the health crises we face today, such as addiction and mental illness, are generational in nature and require ongoing, long-term social support. Yes, a universal health care system is necessary and something to be proud of, but there’s much more we can do. T
ANNIE MACLEOD