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The global financial crisis and health equity: early experiences from Canada.

Ruckert A, Labonté R - Global Health (2014)

Bottom Line: It is widely acknowledged that austerity measures in the wake of the global financial crisis are starting to undermine population health results.This article documents some of the effects of financial crisis and severe economic decline on health equity in Canada.However, more research is necessary to study policy choices that could mitigate this effect.

View Article: PubMed Central - HTML - PubMed

Affiliation: Institute of Population Health, University of Ottawa, Room 216A, 1 Stewart Street, Ottawa, ON K1N 6 N5, Canada. aruckert@uottawa.ca.

ABSTRACT

Background: It is widely acknowledged that austerity measures in the wake of the global financial crisis are starting to undermine population health results. Yet, few research studies have focused on the ways in which the financial crisis and the ensuing 'Great Recession' have affected health equity, especially through their impact on social determinants of health; neither has much attention been given to the health consequences of the fiscal austerity regime that quickly followed a brief period of counter-cyclical government spending for bank bailouts and economic stimulus. Canada has not remained insulated from these developments, despite its relative success in maneuvering the global financial crisis.

Methods: The study draws on three sources of evidence: A series of semi-structured interviews in Ottawa and Toronto, with key informants selected on the basis of their expertise (n = 12); an analysis of recent (2012) Canadian and Ontario budgetary impacts on social determinants of health; and documentation of trend data on key social health determinants pre- and post the financial crisis.

Results: The findings suggest that health equity is primarily impacted through two main pathways related to the global financial crisis: austerity budgets and associated program cutbacks in areas crucial to addressing the inequitable distribution of social determinants of health, including social assistance, housing, and education; and the qualitative transformation of labor markets, with precarious forms of employment expanding rapidly in the aftermath of the global financial crisis. Preliminary evidence suggests that these tendencies will lead to a further deepening of existing health inequities, unless counter-acted through a change in policy direction.

Conclusions: This article documents some of the effects of financial crisis and severe economic decline on health equity in Canada. However, more research is necessary to study policy choices that could mitigate this effect. Since the policy response to a similar set of economic shocks has globally varied and led to differential health and health equity outcomes, comparative studies are now possible to assess the successes and failures of specific policy responses. This raises the question of what types of public policy can mitigate against the negative health equity effects of severe economic recessions.

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Related in: MedlinePlus

Waiting list for affordable housing in Ontario.
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Figure 2: Waiting list for affordable housing in Ontario.

Mentions: Important SDH pathways other than health care have also been affected by the austerity drive. Housing is widely considered to be an important SDH as housing conditions directly influence an individual’s health through the presence of lead and mold, poor heating and draft, inadequate ventilation, vermin, and other structural conditions [30]; as well as the affordability of housing, given high market rental rates, low social welfare entitlements and the ‘working poverty’ of minimum wage jobs. In 2011, there were more than 150,000 households waiting for affordable (publicly subsidized) housing in Ontario (or 3% of all households in the province), an increase of 17.7% since the beginning of the financial crisis (see Figure 2). Yet, the 2012 budget identifies further cuts to the operating budget of the Ministry of Municipal Affairs and Housing, with spending set at $585.5 million, roughly a 12% reduction from fiscal year 2009 [31]. This means that the operating budget has been cut back in every year since the beginning of the financial crisis in 2008. Operational cutbacks are supplemented by cuts to the capital budget, reducing the capacity for the proper (and healthful) maintenance of subsidized housing units. In addition, cutbacks in the federal budget of 2012 to national housing repair and improvement programs are making a bad situation worse, with an astonishing 97% drop from $674 million in 2011 to $37 million in 2012 [32]. Two other critically important housing programs were also phased out in response to the budget crisis, and will mostly impact those on the margins of society, especially social assistance recipients who lost housing repair and moving subsidies. Reinforcing this observation, one informant suggested that “in the most recent budget (2012), if anything, housing was cut further, so it doesn’t look like there has been any improvement in that area”.


The global financial crisis and health equity: early experiences from Canada.

Ruckert A, Labonté R - Global Health (2014)

Waiting list for affordable housing in Ontario.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3974147&req=5

Figure 2: Waiting list for affordable housing in Ontario.
Mentions: Important SDH pathways other than health care have also been affected by the austerity drive. Housing is widely considered to be an important SDH as housing conditions directly influence an individual’s health through the presence of lead and mold, poor heating and draft, inadequate ventilation, vermin, and other structural conditions [30]; as well as the affordability of housing, given high market rental rates, low social welfare entitlements and the ‘working poverty’ of minimum wage jobs. In 2011, there were more than 150,000 households waiting for affordable (publicly subsidized) housing in Ontario (or 3% of all households in the province), an increase of 17.7% since the beginning of the financial crisis (see Figure 2). Yet, the 2012 budget identifies further cuts to the operating budget of the Ministry of Municipal Affairs and Housing, with spending set at $585.5 million, roughly a 12% reduction from fiscal year 2009 [31]. This means that the operating budget has been cut back in every year since the beginning of the financial crisis in 2008. Operational cutbacks are supplemented by cuts to the capital budget, reducing the capacity for the proper (and healthful) maintenance of subsidized housing units. In addition, cutbacks in the federal budget of 2012 to national housing repair and improvement programs are making a bad situation worse, with an astonishing 97% drop from $674 million in 2011 to $37 million in 2012 [32]. Two other critically important housing programs were also phased out in response to the budget crisis, and will mostly impact those on the margins of society, especially social assistance recipients who lost housing repair and moving subsidies. Reinforcing this observation, one informant suggested that “in the most recent budget (2012), if anything, housing was cut further, so it doesn’t look like there has been any improvement in that area”.

Bottom Line: It is widely acknowledged that austerity measures in the wake of the global financial crisis are starting to undermine population health results.This article documents some of the effects of financial crisis and severe economic decline on health equity in Canada.However, more research is necessary to study policy choices that could mitigate this effect.

View Article: PubMed Central - HTML - PubMed

Affiliation: Institute of Population Health, University of Ottawa, Room 216A, 1 Stewart Street, Ottawa, ON K1N 6 N5, Canada. aruckert@uottawa.ca.

ABSTRACT

Background: It is widely acknowledged that austerity measures in the wake of the global financial crisis are starting to undermine population health results. Yet, few research studies have focused on the ways in which the financial crisis and the ensuing 'Great Recession' have affected health equity, especially through their impact on social determinants of health; neither has much attention been given to the health consequences of the fiscal austerity regime that quickly followed a brief period of counter-cyclical government spending for bank bailouts and economic stimulus. Canada has not remained insulated from these developments, despite its relative success in maneuvering the global financial crisis.

Methods: The study draws on three sources of evidence: A series of semi-structured interviews in Ottawa and Toronto, with key informants selected on the basis of their expertise (n = 12); an analysis of recent (2012) Canadian and Ontario budgetary impacts on social determinants of health; and documentation of trend data on key social health determinants pre- and post the financial crisis.

Results: The findings suggest that health equity is primarily impacted through two main pathways related to the global financial crisis: austerity budgets and associated program cutbacks in areas crucial to addressing the inequitable distribution of social determinants of health, including social assistance, housing, and education; and the qualitative transformation of labor markets, with precarious forms of employment expanding rapidly in the aftermath of the global financial crisis. Preliminary evidence suggests that these tendencies will lead to a further deepening of existing health inequities, unless counter-acted through a change in policy direction.

Conclusions: This article documents some of the effects of financial crisis and severe economic decline on health equity in Canada. However, more research is necessary to study policy choices that could mitigate this effect. Since the policy response to a similar set of economic shocks has globally varied and led to differential health and health equity outcomes, comparative studies are now possible to assess the successes and failures of specific policy responses. This raises the question of what types of public policy can mitigate against the negative health equity effects of severe economic recessions.

Show MeSH
Related in: MedlinePlus