Minimum wage in Ontario has been frozen at $10.25 for three
years, which is now 19% below the poverty line. Inspired by fast food and
retail workers in the US, there is a growing campaign across Ontario to raise
the minimum wage to $14/hr. January 14 will be a province-wide call-in day to
Ontario Premier Kathleen Wynne, to demand a $14 minimum wage for health
reasons.
The health impacts of
inequality
There is a growing rediscovery of the ways in which poverty
and inequality undermine health. As an article in The New England
Journal of Medicine explained in 2004: "On the whole, people in lower classes die earlier than do people at
higher socioeconomic levels, a pattern that holds true in a progressive fashion
from the poorest to the richest... Unhealthy behavior and lifestyles alone do
not explain the poor health of those in lower classes. Even when behavior is
held as constant as possible, people of lower socioeconomic status are more
likely to die prematurely."
The same is true in
Canada, as the Ontario
Medical Review explained in a series of articles last year: “Income is a well-recognized
social determinant of health, and people living with low incomes experience
higher burdens of illness, decreased life-expectancy, and higher rates of
mortality than high-income earners. Health declines as one moves down the
income gradient, with differential health outcomes at every level of income. A
recent Statistics Canada report on cause-specific mortality rates by income
quintile highlighted these health disparities. Each successively lower income
quintile was associated with an increase in age-standardized mortality rates
for almost all causes of mortality.” This has a disproportionate impact on
indigenous communities and racialized groups, women, people with disabilities
and others groups whose oppression concentrates them in lower incomes.
Capitalism makes us sick
Social and economic inequality and its health impacts do not abstractly exist, they are actively maintained. In The
Conditions of the Working Class in England, Friedrich Engels wrote in 1845
that “when society places hundreds
of workers in such a position that they inevitably meet a too early and an
unnatural death, one which is quite as much a death by violence as that by the
sword or bullet; when it deprives thousands of the necessaries of life, places
them under conditions in which they cannot live – forces them, through the
strong arm of the law, to remain in such conditions until that death ensues
which is the inevitable consequence – knows that these thousands of victims
must perish, and yet permits these conditions to remain, its deed is murder
just as surely as the deed of the single individual.”
Instead of challenging
this economic model, mainstream medicine came to reflect it—reducing people to
isolated individuals removed from their environment and society. This biological
reductionism has provided ideological justifications for colonization in Canada
and around
the world, and for a rise in fat-phobia
that attributes declines in health to people’s body size instead of their
social and economic conditions.
The social model of medicine is reasserting
itself. In 2008
the World
Health Organization raised the alarm that “social injustice is killing
people on a grand scale”, and we need to “tackle the inequitable distribution
of power, money, and resources.” But austerity measures have done the opposite: prescribing massive
bailouts for banks and corporations while taking a scalpel to jobs, wages and
services. There are claims that recent job numbers show this is leading us to
prosperity, but as economist Joseph
Stiglitz recently wrote this month, “we should curb our euphoria. A
disproportionate share of the jobs now being created are low-paying – so much
so that median incomes (those in the middle) continue to decline. For most
Americans, there is no recovery, with 95% of the gains going to the top 1%.”
Prescription for
health: tax the rich, raise wages, and support unions
Physicians are
starting to follow the advice of Rudolph Virchow, one of the founders of social
medicine: “if medicine is really to accomplish its great task, it must
intervene in political and social life.” Last year the Canadian
Medical Association held a public consultation process about the social
determinants of health. Their findings: “poverty is the most important issue
and must be addressed” and “governments need to be pressured to take action.”
Doctors for Fair Taxation has
called on the Ontario government to increase taxes on the wealthy: “Ontario
physicians see the adverse health impacts of growing inequality in our patients
and our communities. As the government grapples with its financial
difficulties, we urge all political parties to spare the province’s poor, sick,
and vulnerable residents. We think high earning Ontarians are prepared to pay
higher taxes for a fairer society. We say to Premier Wynne and Finance Minister
Sousa: Tax us, Ontario is worth it!”
Health Providers Against
Poverty have developed a clinical
tool kit to factor poverty into clinical decision-making,
considering the evidence of how poverty predisposes to cardiovascular disease,
diabetes, depression, suicide, cancer, hypertension, arthritis, COPD and asthma.
As Dr.
Gary Bloch explained, “Treating
people at low income with a higher income will have at least as big an
impact on their health as any other drugs that I
could prescribe them.”
Unions are another mechanism to prescribe equality, which is
why they are under such sustained attack—from Ontario Tory leader Tim Hudak’s
threat of “right to work” to the federal Conservatives’ recent party
convention. As The
National Post wrote recently, “Forget Duffy. Harper’s war is with unions.” Unions defend wages and conditions, and support broader social justice causes—all of which promote health. Which is why fast food and retail workers in the
US—part of the 99% who are suffering from austerity—are combining demands for a
higher minimum wage with unionization to provide them with democratic structures to resist austerity.
The campaign to raise the minimum wage is part of a broader
struggle to change the world and through the process change ourselves. As psychologists studying protesters found,
social justice is good for our health: “The take-home message from this
research therefore might be that people should get more involved in campaigns,
struggles and social movements, not only in the wider interest of social
change, but also for their own personal good."
*Health Providers Against
Poverty will hold a press conference at 10:30am at the Queen’s Park Media
Studio at the Ontario Legislature
* Join
the phone-in day on January 14th
to tell Premier Kathleen Wynne we need a raise, by calling her office at
(416) 425-6777 and then your local MPP. Find your MPP contact info here.
* Tweet @Kathleen_Wynne: Raise
minimum wage to $14/hr in 2014 #14now #OnPoli
*On January
24 the Campaign to Raise the Minimum Wage is holding a public forum with
organizers leading the fight for fair wages in the US.
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