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PasseportSanté.net attended the big meeting of public health 2008. Almost 250 speakers and 2,000 participants attended the Annual public health days (JASP) which took place in Quebec, from November 17 to 20. An important part of this meeting was devoted to social inequalities in health. |
QUEBEC (PasseportSanté.net) November 20, 2008 – “Do we know enough about social inequalities to take action? The answer is clearly positive: yes, and there is an urgent need to act, because social justice is a matter of life and death and social injustice kills on a large scale. “
This is what Monique Bégin – the first woman to have held the post of Minister of Health in Canada – declared as part of the 12e Annual public health days.
Co-author of a World Health Organization (WHO) report on social determinants of health1, Monique Bégin underlined that great strides had been made in the field of public health in the world in recent decades. But these advances do not benefit everyone equally, she stressed.
“In France, a 35-year-old worker has a life expectancy of seven years less than an executive of the same age, illustrates Monique Bégin. There is no innate reason for the situation to be so. Nor is it predetermined that a little boy living in the West Island of Montreal will have a life expectancy of 79 years, while the one who lives in the city center will live 66 years, or 13 years younger. . “
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Some determinants of health and their concrete consequences2 Work : In Spain, a manual worker who has a permanent job has six times fewer mental health problems than one who is hired without a contract. Income : In Indonesia, maternal mortality3 is three to four times higher among the poor than among the rich. Education and sex: When Kenya abolished user fees that once prevailed for access to school, 1.3 million children enrolled. Mostly girls. Decision-making power: In Burkina Faso and Senegal, only 20% of women can make their own decisions about their own health. In Cameroon, this proportion is 33%; and in Morocco, 41%. |
Canada: far from being an example
If Canada has long prided itself on being one of the countries offering the best living conditions to its citizens, Monique Bégin deflated the myth by shedding light on the social inequities identified in the WHO report.
“There has not been, in Canada, any significant expansion of the education and care system for children under 5 years of age, over the last decade, apart from Quebec which is cited as an example. all over the world in this regard. Less than 20% of children aged 0 to 6 find a place in a regulated childcare service in Canada, ”she lamented.
“By way of comparison,” she continues, “this rate is 63% in Belgium, 78% in Denmark, 69% in France and 60% in the United Kingdom. It is extremely shocking. “
Monique Bégin also said she was outraged by the lack of social housing in Canada, as well as the pitiful living conditions of the homeless. “Poverty in Canada is often invisible: yet it represents a serious problem, present in both urban and rural areas,” she said.
The one who has already taught in disadvantaged areas recalled that 10% of Canadian households live in food insecurity. “Today, twice as many people depend on soup kitchens as in the early 1980s. However, this concept of a food bank was to be a one-off emergency service that was to disappear …”
Capitalism: generator of social inequities
Like other speakers, Monique Bégin in passing flayed the economic system which, according to her, is a source of social inequities.
“All our elites have assured us that capitalism and the laws of the market will serve as a mechanism for the regulation and distribution of wealth. However, we now know that this is a pretty big joke, ”she said.
Thus, she believes that, despite the large sums invested in health in Canada, the country lags far behind the Nordic countries “and even just behind the United States” in terms of social policies and equity.
“The three categories of people most at risk of having to live on social assistance are families with three or more children, single-parent families and the elderly,” she explained. Unlike the Nordic countries, such as Finland, Sweden and Norway, Canada has unacceptable rates of social assistance in all three categories. “
Involve new players
According to Monique Bégin, new actors must participate in the fight against social inequities and act locally on the social determinants of health.
First, the municipalities. “Historically left out of the health debate, they are on the line of fire and it is imperative to connect cities to action on the social determinants of health,” she suggested.
Then, civil society. “Certain professional bodies must come out of their silo to create a rainbow-type coalition to act too: I would like to see teachers, social workers, as well as nurses agree to work together to take ownership of the policies. public ”, suggests the sociologist by training. “This is a long-term job and that is why it is urgent to start now,” she concluded.
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To read other news from our coverage of Lose weight: get rid of old reflexes and develop new ones A “health lens” on the reality of citizens |
Martin Lasalle – PasseportSanté.net
1. Title Closing the Gap in a Generation: Achieving Health Equity by Acting on the Social Determinants of Health, the report of the Commission was made public on August 28, 2008. To obtain a free copy: www.who.int [consulté le 20 novembre 2008].
2. Examples taken from the conference given by Monique Bégin on November 18, 2008.
3. According to the WHO, maternal death is “the death of a woman during pregnancy or within 42 days of its termination, regardless of duration or location, from any cause. determined or aggravated by the pregnancy or the care it motivated, but neither accidental nor fortuitous ”.
