Physician Believes Poverty Reduction is Essential for Good Health

(This story originally appeared at www.hamiltonjustice.ca on August 19th.) 

Earlier this year I attended the annual Ontario Project for Inter Clinic Community Organizing (OPICCO) conference.

This gathering is put together for Community Legal Clinic staff who are involved in and want to learn more about community development work.

One of the really interesting speakers at this year’s conference was Dr. Gary Bloch.

Gary is a family physician who works out of St. Michaels Hospital in Toronto.

His presentation focused on the social determinants of health. The twenty-minute talk zeroed in on one particular social determinant of health – i.e., poverty. Gary told us “poverty accounts for 24% of person years of life lost in Canada.” That figure is second only to 30% of person years of life lost for cancers.

One significant resource Bloch made us aware of was a four pager called a Clinical Tool for Primary Care in Ontario. This is a resource for family docs that will help them in patient diagnosis. It will help physicians to keep in mind that poverty is a health condition that needs to be treated like other medical conditions. (http://www.ocfp.on.ca/docs/default-source/cme/poverty-a-clinical-tool-2013-(with-references).pdf?sfvrsn=0 )

Bloch has a unique approach to practicing medicine. In a Globe and Mail story, he wrote earlier this year emphasized the importance of tax filing. http://www.theglobeandmail.com/commentary/as-a-doctor-heres-why-im-prescribing-tax-returns-seriously/article9981613/

A patient named Rena told Bloch he could make her better by getting her more money. But Gary determined that Rena had not always filled out her tax return.
“Suggesting Rena fill out her tax return is prescribing income. And prescribing income can be just as powerful as prescribing medications for her blood pressure or her mood,” wrote Bloch.

Bloch wrote about another patient in a story in the Huffington Post. http://www.huffingtonpost.ca/gary-bloch/income-inequality-and-health_b_2003259.html

Tom is a 46 years old skilled carpenter who hurt his back in a car accident 8 years ago. He has been forced to live on social assistance.
“For him, social assistance has not been so much a safety net as it's been a fish net -- a trap of indignity from which he has been unable to wriggle free,” said Bloc.

Similar to the views of the Clinics, Bloch believes that there should be a level of social assistance support that allows for a dignified standard of living.

“Forcing people to live in squalor and survive on less than a pittance only worsens the health impacts of their low income. While this may appear to save money up front, it likely ends up being spent elsewhere, through higher use of physical and mental health services down the road.”

While Gary Bloch views may stand out as unique for a physician, the ground is shifting in the Canadian medical world. The Canadian Medical Association has just completed a consultation. Their conclusion is that poverty is the main issue that must be addressed to improve the health of Canadians.