June – Many factors contribute to health-care crisis in Peterborough

Written by Comms Team, June 21, 2022

The solutions are not intuitive, writes the area’s medical officer of health.

We hear a lot about crises these days. Whether it’s the climate crisis, the housing crisis, the drug poisoning crisis, or the health care crisis, it seems crises are constant and worsening. The challenge with these complex crises, is that they have been decades or longer in the making, and the solutions to preventing them will take many years to take effect.

But working toward prevention is still critical because as the old saying goes, an ounce of prevention is worth a pound of cure, and we just can’t afford to keep piling up the pounds and pounds of cure.

Of particular concern to me in public health is the crisis that’s affecting the health care system in Ontario. You’ve likely experienced this first hand with struggles finding a family doctor, health care staff sick and burnt out, and long delays to get care by our hard working hospital and community providers.

The challenge, and it’s not intuitive, is that more health care, more “pounds of cure,” is not the most important solution to the health care crisis. We need to prevent the demands being placed on the health system in the first place. Social factors play a significant role in determining a person’s health that of our population. Only a quarter of what makes you healthy is access to health care when you get sick. Three quarters or more comes from your environment and social issues like income and housing, among other determinants, that make and keep you healthy in the first place.

Studies show that increases in funding for social spending (social services, income supports etc) are more important to making us healthy than increases in health care spending. Funding for health care in Ontario, adjusting for inflation, has doubled in the past 40 years. But in this period, social spending, spending that helps make us healthy and prevents illness in the first place has stagnated.

Living is also becoming more expensive and the gap between the rich and poor, known as inequality, is growing. Basic needs such as food and shelter, are becoming unaffordable for many. Minimum wage remains at $15.50 while the living wage, or the wage that the average person needs to make to sustain a modest life, here in Peterborough, is $18.35.

The social safety nets in place like ODSP and OW are also not enough to live healthy. The average funding for ODSP has remained stagnant since 2005 with OW increasing only marginally. People cannot afford their basic needs, leaving healthy decisions to be their last priority.

Housing here in Peterborough is unaffordable to many. In 2021, At least 34 per cent of Peterborough residents would have to spend more than 30 per cent of their income to pay the average market rent. And the cost of rental housing in Peterborough is increasing faster than both inflation and wage increases. Purchasing a home is a fantasy to most. Making a modest living is tough and finding a safe and comfortable place to live is even harder.

The impact this all has on health is stark. If you can’t afford healthy food, or a place to prepare it, chronic diseases such as obesity, diabetes, heart disease and cancers go up. Poverty and trauma breed substance use and addictions, as people cope with difficult circumstances. If you can’t afford safe shelter then you’re exposed to the elements, suffer injuries or are more at risk for the spread of diseases like COVID-19.

All of these ultimately weigh down our health care system. It is clearly getting worse, ask any health care provider about the preventable issues they see daily. The burden this places on our health care providers is tremendous, and it burns them out.

Our work in public health is designed to bridge the gap between social and health care systems. Public health units deliver programing to help on both sides of this gap.

Public health and social investments keep people out of hospitals and reduce our need to increase health care spending. The work we do locally in public health is critical and reaches so much further than what you saw us doing for our community during the pandemic. Over the next few months you will learn more about public health’s recovery from the pandemic and our strategic planning efforts to help us prioritize what comes next for the work we do. The same conversations are needed broadly, including in health care, as we continue the journey of living with COVID and the challenges it has added to a health care system already in crisis. But in this we need to be mindful that piling on more pounds of cure won’t get us out of these crises.