Limits...
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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Poverty and food bank usage in Ontario.
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Figure 3: Poverty and food bank usage in Ontario.

Mentions: Even before the austerity agenda started to take effect in 2012, food insecurity had reached an unprecedented level in Canada. Food security trends in Canada have been measured since 2005 through the Canadian Community Health Survey, with food insecurity defined as lacking access to nutritious food in sufficient quantity and of sufficient quality to maintain good health [35]. Since 2005, food insecurity has been increasing in Canada, with a significant acceleration since the onset of the GFC. By 2011, 12.3% of Canadian households experienced some level of food insecurity, and a rise from 11.3% in 2008, affecting an additional 450,000 Canadians [35]. Growing food insecurity is further manifested through increased usage of food banks. During the month of March 2012, roughly 3% of the population received food from a food bank in Canada, an increase of 2.4% over 2011, and 31% higher than in 2008 [36]. The increase was greatest in Ontario, with roughly 5% of Ontarians (or 650,000 individuals) now considered food insecure [37]. Importantly, working people are increasingly seeking food bank assistance, leading the UN special rapporteur on the right to food to criticize Canada for lacking a proper food security strategy for people living in vulnerable conditions. Poverty rates are also on the rise. Poverty in Canada is generally measured through use of the Low-Income Measure (LIM), a relative measure of poverty that defines the poverty line as 50% of median income after adjusting for family sized. The LIM has been trending upwards in Ontario from 8.3% in 1990 to 13.1% in 2010 [38] (see Figure 3).


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

Ruckert A, Labonté R - Global Health (2014)

Poverty and food bank usage in Ontario.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 3: Poverty and food bank usage in Ontario.
Mentions: Even before the austerity agenda started to take effect in 2012, food insecurity had reached an unprecedented level in Canada. Food security trends in Canada have been measured since 2005 through the Canadian Community Health Survey, with food insecurity defined as lacking access to nutritious food in sufficient quantity and of sufficient quality to maintain good health [35]. Since 2005, food insecurity has been increasing in Canada, with a significant acceleration since the onset of the GFC. By 2011, 12.3% of Canadian households experienced some level of food insecurity, and a rise from 11.3% in 2008, affecting an additional 450,000 Canadians [35]. Growing food insecurity is further manifested through increased usage of food banks. During the month of March 2012, roughly 3% of the population received food from a food bank in Canada, an increase of 2.4% over 2011, and 31% higher than in 2008 [36]. The increase was greatest in Ontario, with roughly 5% of Ontarians (or 650,000 individuals) now considered food insecure [37]. Importantly, working people are increasingly seeking food bank assistance, leading the UN special rapporteur on the right to food to criticize Canada for lacking a proper food security strategy for people living in vulnerable conditions. Poverty rates are also on the rise. Poverty in Canada is generally measured through use of the Low-Income Measure (LIM), a relative measure of poverty that defines the poverty line as 50% of median income after adjusting for family sized. The LIM has been trending upwards in Ontario from 8.3% in 1990 to 13.1% in 2010 [38] (see Figure 3).

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