Trevor Hancock: We simply can’t afford the costs of poverty

One of the most important consequences of the poverty that Sarah Petrescu has been documenting in the Times Colonist is the health impact. It’s no secret that poverty is bad for health. Here’s how bad:

• The poor die young. Men living in the poorest 20 per cent of neighbourhoods in Canada in 2005-07 had a life expectancy at birth of 75.6 years, but 80.3 years in the richest 20 per cent, a gap of almost five years; in B.C., it was 76.3 years versus 80.9 years. For women, life expectancy was longer and the gap smaller: 81.7 versus 84 years in Canada; 82.1 versus 84.8 years in B.C.

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• A 2008 report from Hamilton’s McMaster University found children living in poverty are three times more likely to experience mental-health problems.

• In 2010-11, the lowest income 20 per cent of Canadians experienced 1.37 times the rate of hospitalization for heart attack and 1.27 times the rate for injury.

It is not hard to understand why those living in poverty have worse health and die younger than their better-off fellow citizens. They are much more likely to experience food insecurity, live in less safe and healthy housing and neighbourhoods, be less well educated, and have more unstable and unhealthy work.

Of particular concern is the health of aboriginal people. As B.C.’s provincial health officer has reported, life expectancy in B.C. in 2006-10 among “status Indians” was 74.7 years, 6.4 years lower than in non-aboriginal people. Not only are they often dealing with the same issues of poverty, they are further harmed by a history of colonization, racism, dispossession of land, and loss of culture and self-determination.

The scale of the health impacts of poverty is large. As a risk factor for disease and early death, it ranks with smoking, which we usually describe as the most important cause of preventable death and disease. This suggests that poverty reduction should be as important to society as tobacco reduction has been.

But it is not just that the poor experience a greater burden of disease and early death; there are social and economic costs. The Canadian Centre for Policy Alternatives estimates that the direct health costs of poverty in B.C. were $1.2 billion, or almost seven per cent of the health budget.

And when the CCPA included costs due to poverty-associated crime and reduced economic activity (lost production, lost income and lost tax revenues), it concluded that poverty costs between $8.1 billion and $9.2 billion per year. This is more than double what it would take to markedly reduce poverty by investing in a poverty-reduction strategy. In short, poverty is so expensive, and such a drag on our economy, that we simply can’t afford it.

It is not just the CCPA that reaches such conclusions. The Conference Board of Canada — hardly a hotbed of radicalism — in its report How Canada Performs, points to a 2005 OECD report that states “failure to tackle the poverty and exclusion facing millions of families and their children … will also weigh heavily on countries’ capacity to sustain economic growth.”

The massive health and social costs of poverty are the reason that B.C.’s Health Officers Council and the Public Health Association of B.C. have joined their voices with many others in calling for a poverty-reduction strategy. Sadly, B.C. is the only province that does not have such a strategy.

At a time when we are concerned with the sustainability of our health-care system, reducing this additional burden of disease should be a priority for governments. Responsible public policy requires reducing poverty to reduce the economic costs of the health consequences of poverty. The added benefits of reduced costs elsewhere and the gain in human potential and social well-being are additional benefits we should be reaping.


Dr. Trevor Hancock is a professor and senior scholar at the University of Victoria’s school of public health and social policy.

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