Wednesday, December 24, 2008

Happy Holidays!

Wishing everyone a very happy holiday season and a wonderful new year to come!
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Barriers to Health Equity: Access to language interpretation

Simple yet so complicated..

This week, HealthZone published an article about the critical role played by language interpretation in creating accessible and equitable health care. Although the importance of proper interpretation is well known, there remain major challenges in accessing and financing appropriate services.

Pointing to the informal family interpretation that often occurs, Axelle Janczur, Executive Director of Access Alliance Multicultural Health and Community Services, is quoted as saying "Doctors spend hundreds of thousands of dollars on their education and then ask a child to deliver a diagnosis."

Dr. Jose Silveira, director of Portuguese Mental Health and Addiction Services at the University Health Network, suggests that extensive damage is caused by the lack of interpretation. He notes that "[i]t is easier...to order a $1,400 CT scan than a translator ... even though that information will be more valuable than a CT scan...It's up to me to decide on enormously expensive medical tests. It's up to the hospital administration to decide on interpreters."

The article can be read here:
http://www.healthzone.ca/health/article/557666
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Friday, December 19, 2008

No Cherries Grow on Our Trees - gendering Ontario's poverty reduction strategy

Earlier in December, I blogged about the release of the provincial government's Poverty Reduction Strategy report and the response from anti-racism groups, including the Colour of Poverty network.

This week, METRAC, the Metropolitan Action Committee on Violence Against Women and Children, shared concerns about the exclusion of women’s realities from the Strategy. No consideration of the gendered dimensions of poverty was included, despite the November launch of METRAC’s report on the subject, No Cherries Grow on Our Trees.

You can read the full METRAC release below and I will post a link to the full report when it is available.

MEDIA RELEASE
December 16, 2008

Ontario Women’s Groups decry lack of gender focus in Province’s Poverty Reduction Strategy.

More than 50 women’s agencies from across Ontario partnered in a policy research paper designed to inform the government of the female gendered nature of poverty. Submitted to Minister Deb Mathew’s office last month, the report titled “No Cherries Grow On Our Trees” concludes and provides clear evidence that:

  • Women are disproportionaly affected by poverty and in particular Aboriginal, racialized, older and immigrant women and women with disabilities.
  • Women’s poverty often traps them in abusive intimate, employment, and caregiving relationships.
  • Violence and poverty in Ontario are seriously impacting women’s human rights and their physical, emotional and spiritual health.

The project was funded by United Way Toronto and designed by the Metropolitan Action Committee on Violence Against Women and Children (METRAC) in an effort to address child poverty by acknowledging the poverty of their (often single parent) mothers. The research was conducted by Janet Mosher, Assistant Dean of Law at York University and contains numerous recommendations for change.

“Although the Ministry indicated their support of our work before they released their plan, we are dismayed that the Poverty Reduction Strategy has no meaningful analysis regarding gender, poverty’s connections to violence, and the impact of race”. says Project Coordinator Nora Currie.

Wendy Komiotis, Exectutive Director of METRAC adds: “At a time of economic recession, in a month of hyper consumerism- that also commemorates the reality of violence in women’s lives - we regret that our political leaders did not hear the voices, analyses and recommendations of experts in the area of poverty and violence and especially those women and their children who experience it daily”

An Executive Summary and the full version of No Cherries Grow on our Trees with a list of the project partners are attached below. For further information and interviews please contact:

Nora Currie
METRAC
416-929-0580


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Monday, December 8, 2008

Where exclusion meets belonging

Today, a colleague and I went to the ‘Indigenous and Racialized Communities, Mental Health and Access to Justice Forum’ organized by Parkdale Community Legal Services (PCLS) at Ryerson University. Lots of food for thought! The speakers shared their thoughts on how mental health, racism, colonization, poverty and gender come together and shape experiences of immigration, policing and incarceration, income security/poverty, and employment.

In her welcoming words, Ayshia Musleh, Community Legal Worker at PCLS, invited us to share the event organizers’ goal of building social change through greater social inclusion. Since we all knew some of the issues, she said, it was time to think about solutions. To this end, she encouraged us to approach the event in the spirit of moving forward.

I found it striking that almost all of the speakers' stories told of how marginalized identities are criminalized. Almost every speaker gave examples of policies and practices that criminalize already marginalized people, excluding them from the social norm and further stigmatizing them.

Some examples shared today were:

Immigration and refugee status
  • Migrant workers whose status, defined by a temporary visa, is tied to their employer, but who could be unfairly dismissed
  • Undocumented or non-status individuals who are considered criminals simply by virtue of being who they are, where they are…and the (inappropriate?) role played by municipal law enforcement in policing immigration violations
  • The retraumatizing impacts of refugee or asylum determination system and the impacts of mental health challenges on immigration/refugee applications (e.g. Sponsorship debt for OW/ODSP use etc.)
  • The impact of criminal charges (in many cases, unfounded) on individuals’ immigration cases
First Nations Communities
  • The vastly disproportionate numbers of incarcerated Aboriginal people
  • The need to approach justice and well being from an understanding of the context of ongoing colonization
  • The Supreme Court of Canada, R. v Gladue, 1999 decision
Poverty and Homelessness
  • Safe Streets Act and control over access to public space
  • Tickets for panhandling, loitering, etc.
  • Eligibility determinations for OW/ODSP
Mental Health or Disabilities
  • Mental Health Police Records
  • Possibilities of immigration inadmissibility due to psychiatric diagnosis
  • Inappropriateness of mainstream policies/services with severe consequences
And more…

Thinking this over now, I am reminded that these practices also play an important role in shaping social inclusion or who does belong. One speaker commented that exclusionary and marginalizing practices, such as Ontario's Safe Streets Act, 1999, are often justified in the name of the ‘greater good.’ By saying this, it is clear that some people, the ones affected by the Act, are not part of this ‘greater good.'

Who is part of the greater good? Who isn't? What do you think?

I’m looking forward to reading the notes of today’s discussion and our shared solutions. They will eventually be posted on PCLS’s website at: http://www.parkdalelegal.org/.


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Friday, December 5, 2008

Poverty is Not Colour Blind

The Colour of Povery Campaign has issued a media release in reponse to the government of Ontario's povery reduction strategy:

Poverty is Not Colour Blind: Colour of Povery Campaign warns Ontario Government ahead of release of poverty-reduction strategy

TORONTO, December 3, 2008—Members of the Colour of Poverty Campaign today warned the Ontario Government that its pending poverty-reduction strategy – with its narrow focus on child poverty – risks failure by ignoring the root causes of poverty, especially the needs of Ontario’s racialized communities.

“Racism creates poverty, it’s as simple as that,” says Debbie Douglas, Executive Director of the Ontario Council of Agencies Serving Immigrants (OCASI).

“Systemic racism is an extreme and insidious form of discrimination that persists in Ontario at all levels of society and denies its victims opportunities to participate fully in society. It is no wonder racialized people are disproportionately vulnerable to poverty in Ontario.”

Member groups of the Colour of Poverty Campaign, which previously met with Minister of Children and Youth Services Deborah Matthews to discuss the province’s comprehensive poverty-reduction strategy, are concerned that the Government’s announcement tomorrow excludes critical policy considerations for visible minorities.



“Premier Dalton McGuinty has scaled back commitments by his government to build a comprehensive poverty-reduction strategy for Ontario by focusing only on children,” says Avvy Go, Clinic Director of the Metro Toronto Chinese and South-east Asian Legal Clinic. “While noble in intent, it would appear his government is willing to settle for band-aid solutions, instead of addressing the root causes of poverty.”

“A plan that focuses solely on child poverty cannot be effective without clearly addressing the particular needs of children from the diverse ethno-racial minority communities in Ontario,” Go added.

Indeed, a report released yesterday by the Children’s Aid Society of Toronto states: “Poverty is racialized, that is, disproportionate to people of colour who are Canadian-born and newcomers.”

The CAS report, Greater Trouble in Greater Toronto: Child Poverty in the GTA (pg. 12), found among racialized groups in the Toronto CMA (based on 2000 LICO Before-Tax rates) that one child in ten among global European groups lived in poverty; one child in five of East Asian heritage grew up poor; one child in four for Aboriginal, South Asian, Caribbean, South and Central American groups was also living in poverty. Poverty also struck one child in three for children of Arab and West Asian groups and • one child in two for children of African groups.

As a further example, the United Way of Greater Toronto’s “Poverty by Postal Code” analysis showed that poverty among “visible minority” or racialized groups in Toronto rose by 361% between 1980 and 2000, while it actually fell by 28% among the rest of the population.

“Poverty affects different groups of Canadians differently, whether they are immigrants or Canadian born,” says Grace-Edward Galabuzi, Professor of Politics and Public Administration at Ryerson University in Toronto. “Poverty also shows up in inequitable learning outcomes, unequal access to health care and unequal access to the labour market. An effective anti-poverty strategy must recognize poverty’s differential impacts on women, racialized people, Aboriginal people and people with disabilities.”

“Good public policy on poverty reduction should target a framework that recognizes not only children and families, but also individuals and communities that are exposed to poverty due to their race and other factors,” says Atulya Sharman, Community Legal Worker at the South Asian Legal Clinic of Ontario.

“It should address the various forms of structural and institutional inequality that prevail across the broadest range of economic, cultural, community and social services and supports – most especially those that impact differentially and clearly disproportionately on the basis of ethno-racial identity, Aboriginal status, disability, citizenship or immigrant status, family status, sexual orientation and age.”

The Colour of Poverty Campaign has formulated a list of priority measures that Government should implement to address the growing reality of racialized poverty in Ontario, including:

  1. Employment Equity to ensure equal access to opportunity and promotion for Ontario’s visible minorities, and other historically disadvantaged groups;
  2. Establishing an Anti-racism Directorate within Government, ideally with links to the Premier’s Office and with a clear and strong cross-Ministerial mandate. In further support of efforts to counter racialized poverty, Government appointments as well as public service hiring should reflect Ontario's cultural diversity (racialized communities), although it is not acceptable to engage in tokenism to gain support for poor policy making;
  3. Improved employment standards to eliminate precarious and exploitative workplace practices and related disadvantageous forms of employment;
  4. Development and effective implementation of an equitable and inclusive education curriculum, particularly in elementary and secondary school grade levels;
  5. Develop a clear and effective equity framework for delivery, monitoring and measurement of public policy and program outcomes across all of government with the goal of eliminating institutional, structural and systemic bias and disadvantage, especially as it affects visible minorities (racialized groups) and other historically marginalized communities.
  6. Build a comprehensive housing strategy including targeted social housing allocations, inclusive zoning provisions and home ownership supports for racialized communities.
  7. Ensure equitable access to affordable, good-quality child care for all families
    Members of the Colour of Poverty Campaign from around the province also support key related poverty reduction initiatives, including: removing the 3-month waiting period for OHIP eligibility, providing for equitably accessible and effective legal services and litigation supports, and the opening up of the municipal franchise to all residents of any given municipality.


“Ontario’s forthcoming poverty reduction strategy must clearly tackle the causes and consequences of racialized poverty in all areas of government policy and programming, so that all Ontarians will have an equal chance at escaping poverty,” Go said.

For further information about the Colour of Poverty Campaign, please contact:
Amy Casipullai, Ontario Council of Agencies Serving Immigrants (OCASI), at 416-322-4950 ( Mobile – 416-524-4950 )

Atulya Sharman, South Asian Legal Clinic of Ontario (SALCO), at 416-487-6371 ( Mobile – 416-837-0888 )

Avvy Go, Metro Toronto Chinese and Southeast Asian Legal Clinic, at 416-971-9674 ( Mobile – 647-271-9357 )

For related research and background information, please visit: http://www.colourofpoverty.ca/




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Breaking the Cycle: Ontario's Povery Reduction Strategy report released

Yesterday, the Ontario goverment released its poverty reduction strategy report.

The report can be read here:
http://www.growingstronger.ca/english/pdf/Ontario's_Poverty_Report_EN.pdf
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Wednesday, December 3, 2008

Rainbow Health Ontario website launched!

Check out this great new resource for LGBTQ health resources:

Rainbow Health Ontario (RHO) is pleased to announce the launch of our new website:* www.RainbowHealthOntario.ca

RHO is a province-wide program that works to improve the health and well-being of lesbian, gay, bisexual and trans people in Ontario through education, research, outreach and public policy.





Our mission is to improve access to services and to promote the health of Ontario*s lesbian, gay, bisexual and trans communities.

We are based at Sherbourne Health Centre in downtown Toronto and our team consists of 4.5 staff in Toronto and 14 part-time Community Outreach Team members, one in each of Ontario's Local Health Integration Networks (LHINs).

Our comprehensive website provides:

  • A Resource Database featuring LGBT health and wellness
    resources from Ontario, Canada and around the world
  • An LGBT Provider Directory listing LGBT-positive service
    providers and programs around the province
  • A Trainer Database featuring profiles of trainers and educators
    who provide LGBT education and training in Ontario
  • A Researcher Database featuring profiles of LGBT health
    researchers from academic institutions across Ontario
  • An Events Calendar listing upcoming LGBT health and
    wellness-related events and activities across the province, as well as
    events of interest outside of Ontario

We welcome contributions to all of these areas of the RHO website. We invite everyone to submit their health and wellness resources to the Resource Database and their events to the Events Calendar. If you provide a health or wellness program or service to LGBT people, we invite you to be included in the LGBT Provider Directory. If you are a Trainer or a Researcher, we invite you to submit your profile for inclusion in our databases.

We encourage you to share this information with your community members,
friends and clients across Ontario.

To learn more, please visit: www.RainbowHealthOntario.ca



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Toronto Events: International Day of People with Disabilities



The City of Toronto and community partners invite you to celebrate with us.
Wednesday, December 3, 2008
9:30 a.m. - 1:30 p.m.
Villa Colombo, Sala Caboto
40 Playfair Avenue (Dufferin St. & Lawrence Ave. W.)
• Celebrate Unsung Heroes
• Imagination session
• Invitation to Poetry readings
• Displays
• Refreshments
RSVP as space is limited
416-338-4756
TTY: 416-338-0889
Attendant services and captioning provided

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Don't DIS My Ability - December 3rd - International Day of People with a Disability

From the UN website http://www.un.org/disabilities/default.asp?id=109:

"Dignity and justice for all of us is the theme of this year’s International Day for Persons with Disabilities, as well as for the 60th anniversary of the Universal Declaration of Human Rights.
Dignity and justice for all persons are established universal principles. Since its inception, the United Nations has recognized that the inherent dignity and the equal and inalienable rights of all members of the human family are the foundations of freedom, justice and peace in the world. These principles, along with equality and non-discrimination, have guided the work of the United Nations for the past 60 years and are enshrined in various instruments such as the UN Charter and the Universal Declaration of Human Rights, as well as in treaties such as the International Covenants on Human Rights, and the Convention on the Rights of Persons with Disabilities. These instruments are among those which make up the international human rights framework, are complementary and reaffirm that all human rights are universal, indivisible, interrelated, interdependent and mutually reinforcing. "

Check out the Don't DIS My Ability campaign in Australia:
http://www.internationaldayofpeoplewithadisability.com.au/
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Monday, December 1, 2008

One Million Red Ribbons



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EVENTS: World AIDS Day - Toronto

ACT (AIDS Committee of Toronto) events listing:
http://www.actoronto.org/home.nsf/current/current
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World Aids Day and a Day With(Out) Art


December 1st is World AIDS Day -- a day to build community, honour and commemorate those lost to AIDS and those living with the effects of HIV/AIDS. World AIDS Day is also a day to mark achievements and reflect on the work to be done in the fight against HIV/AIDS [adapted from the Canadian AIDS Society site].

Some general resources and links:
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A Day With(Out) Art



Frank Moore, Spring, 1996, Private Collection.

Courtesy Sperone Westwater and the Gesso Foundation

A Day Without Art (DWA) began on December 1st 1989 as the national day of action
and mourning in response to the AIDS crisis. To make the public aware that
AIDS can touch everyone, and inspire positive action, some 800 U.S. art and
AIDS groups participated in the first Day Without Art, shutting down
museums, sending staff to volunteer at AIDS services, or sponsoring special
exhibitions of work about AIDS. Since then, Day With(out) Art has grown into
a collaborative project in which an estimated 8,000 national and
international museums, galleries, art centers, AIDS Service Organizations,
libraries, high schools and colleges take part (Visual AIDS website).

In 1997, Visual AIDS, the organization behind this movement, suggested that the event be marked as a Day With Art as a way to focus on the growing body of artworks that engage and highlight the importance of putting HIV/AIDS in the spotlight: http://www.thebody.com/visualaids/dwa/index.html.

In 2002, the National Gallery of Canada commemorated World AIDS Day with a focus on the work of AA Bronson and General Idea: www.gallery.ca/english/554_824.htm.

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Wednesday, November 26, 2008

EVENT: An Evening of Reflection & Hope - December 1

An Evening of Reflection & Hope

Date - Monday, December 1, 2008
Time - 6-8:30pm
Location - Lula Lounge 1585 Dundas St. W. (West of Dufferin - TTC accessible.)

Please join us for a reception, an Evening of Reflection & Hope, in support of the YWCA December 6 Fund, providing interest free loans to women fleeing violence.

Enjoy Lula Lounge, a Latin-inspired and lively venue, with classy cocktails and canapés at the beginning of the holiday celebration season. After an opening memorial to remember the women lost to violence on December 6, 1989 and over the past year, you will enjoy live music by Latin Jazz artist Lady Son, and have an opportunity to mix and mingle with some of our City’s most interesting and engaging women.

Tickets are $75 each and include hors d’oeuvres and a complimentary cocktail. This YWCA December 6 Fund event, supports the YWCA December 6 Fund, allowing women and their children to leave violent homes by granting them greater safety with interest-free loans; easing the financial burden of leaving an abuser and starting all over again. The December 6 Fund was established in 1994, to commemorate the 14 women murdered at L’École Polytechnique in Montreal on December 6, 1989. Since its inception, more than 730 women have directly benefited from these loans. In 2007, 85 women and 122 children accessed over $56,800 in loans. In April2007, the December 6 Fund became a YWCA Toronto program.

Please note that we will have guest registration on the night of the event. Please bring a copy of your printed confirmation of ticket purchase to the guest registration desk. Tickets will not be mailed in advance.

Also available in limited quantity:
Tables for 5 people for $650 and include hors d’oeuvres, a complimentarycocktail and tax receipt for $275. Tables for 8 people for $1000 and include hors d’oeuvres, acomplimentary cocktail and tax receipt for $400.


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South Asian Health Fair - December 6, 2008

The South Asian Health Coalition of York Region (SAHCYR) is a not for profit group made up of equal partnership from Blue Hills Child and Family Centre, Canadian Cancer Society, Canadian Diabetes Association, Family Services York Region, Heart and Stroke Foundation of Ontario, Kinark Child and Family Services, Social Services Network, and York Region Health Services. This coalition was formed with the mandate to provide the South Asian residents of York Region and Greater Toronto Area with information to promote healthy lifestyles.

The 2008 Health Fair Event for the South Asian community will take place on Saturday, December 6th 2008 at Alexander Mackenzie High School (300 Major Mackenzie Drive West Richmond Hill L4C 3S3) from 10:00am to 4:00pm. The health fair will provide the Asian community with greater awareness and knowledge about the importance of adopting a healthy lifestyle to promote overall wellness and reduce their risk of developing chronic diseases. This event is expected to be attended by over 2,000 Over 60 Exhibitors will be participating and will include interactive booths and Healthy cooking demonstrations and many exciting speakers, and displays. Over 1600 community members participated in last year’s event, as well as many of the local politicians.

Confirm participation by November 26, 2008 at (905) 940-7864 or narain@socialservicesnetwork.org.
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Wednesday, November 19, 2008

First Steps to Equity - Ideas and Strategies for Health Equity in Ontario, 2008-2010

Dianne Patychuk and Daniela Seskar-Hencic have released a report entitled "First Steps to Equity: Ideas and Strategies for Health Equity in Ontario, 2008-2010" to mark the Nov 12-14 launch of the new Ontario Public Health Standards.

The authors write:
With this document, we celebrate the launch of new Ontario Public Health
Standards that include identifying, reporting and using information about
health inequities and tailoring strategies to inform actions that meet the
needs of priority populations. This document provides some ideas, steps,
examples and resources to support people and organizations working for equity
in health in Ontario. Equity in Health is about eliminating unnecessary/avoidable, and unfair/unjust differences in health among population groups and communities.

The document is available in .pdf format at:

http://www.healthnexus.ca/policy/firststeps_healthyequity.pdf

More information about the new Ontario Public Health Standards here:

http://www.health.gov.on.ca/english/providers/program/pubhealth/oph_standards/ophs/index.html

The 2008 Ontario Public Health Standards can be viewed here:

http://www.health.gov.on.ca/english/providers/program/pubhealth/oph_standards/ophs/progstds/pdfs/ophs_2008.pdf


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Friday, November 14, 2008

The Roots of Youth Violence Review

The Roots of Youth Violence Review was released today by the Ontario provincial government. The Review was established in 2007 by Premier Dalton McGuinty, and was co-chaired by former Chief Justice and Attorney General Roy McMurtry and former Speaker of the Legislature Alvin Curling. The purpose of the review was to identify and analyse some of the contributing factors to youth violence in the province in order to develop policy and planning recommendations.

The report highlights the critical importance of developing strong public policy that addresses racism, neighbourhood marginalization, affordable housing, and income disparities:

The very serious problems being encountered in neighbourhoods characterized by
severe, concentrated and growing disadvantage are not being addressed because
Ontario has not placed an adequate focus on these concentrations of disadvantage
despite the very serious threat they pose to the province’s social fabric. Racism is becoming a more serious and entrenched problem than it was in the past because Ontario is not dealing with it. The significant new investments in education are not reaching many of the children who need
the most help because long-identified barriers to learning are not being addressed. Ontario’s youth justice system is harming some youth because it has no overall coordination, remains punitive in ways that are not strategic and permits increasingly problematic police-community relations (page 3).

It is further added that:

The worst impacts are being felt in neighbourhoods that are often already isolated from the rest of the community because of the circumstances of poverty. What is particularly disturbing is that many of these communities are largely composed of members of racialized groups. We trace in Chapter 4 how racism and other barriers have concentrated poverty in these groups, and
how the housing market has then driven them into concentrations of those who
suffer from high levels of poverty. When poverty is racialized, and then ghettoized and
associated with violence, the potential for the stigmatization of specific groups is high. That stigmatization can, in turn, further reduce opportunities for those groups. If we allow these trends and impacts to grow in intensity and impact and fail to mobilize as a society to
address the conditions that give rise to them, the prognosis for the neighbourhoods and for the future of this province could be grim (page 4).

The full report can be viewed here:

http://www.rootsofyouthviolence.on.ca/english/reports.asp

A CTV article about the report can be found here:
http://toronto.ctv.ca/servlet/an/local/CTVNews/20081114/youth_violence_081114/20081114/?hub=TorontoNewHome


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Thursday, October 30, 2008

Building Equitable Partnerships Symposium: Reducing Health Disparities Through Collaborative Action

The Health Equity & Community Engagement Team is joining forces with the Chester Le Community Coalition and the CEAPC (Community Education and Access to Police Complaints) project on Thursday, November 7, 2008, at the Building Equitable Partnerships Symposium. We will be leading a workshop called Partnering for Change: Working together to create tools for advocacy, equity and community-building.

Our workshop brings together three very different partnerships -- different geographies, goals, structures, and challenges -- that all came together to inspire and effect change. While the Equity Toolkit project focuses on organzational and social change related to health inequitites, the Chester Le Community Coalition supports grassroots-level community change within its North-West Scarborough area, and the CEAPC project seeks to effect structural and policy level change around the issue of police complaints in Ontario.

Each experience also offers an exciting model for how and why partnerships can assist individuals and groups to come together to achieve their goals.

To learn more and participate in the symposium, visit the event website at: http://www.camh.net/News_events/CAMH_Events/bep_symposium_2008.html
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Thursday, October 23, 2008

The Unequal City: Income and Health Inequalities in Toronto (2008)

Yesterday, Toronto's Medical Officer of Health unveiled a report on health inequities in the City of Toronto.

The report can be viewed here: http://www.toronto.ca/health/map/pdf/unequalcity_20081016.pdf

Here is the Executive Summary of the report:

This report presents new data for Toronto showing a clear link between health and income across our city. Those areas of Toronto that have a greater proportion of people living with low income experience greater risk factors for illness, higher rates of disease, and death at an earlier age. Areas with a smaller proportion of low income - areas that are relatively richer - have better health. These differences are referred to as health inequalities.

A number of the health inequalities in this report are cause for concern. For example, when compared to residents of high income areas, lung cancer incidence was 1.5 times higher for males in the lowest income quintile; the gonorrhoea rate among female youth was 3.5 times higher in the lowest income quintile; and the percentage of female adults whose last visit to the dentist was more than three years ago was about 4 times greater in the lowest income group.



The report also shows that males in the highest income areas were expected to live 4.5 years longer than males in the lowest income areas. The difference for females was 2.0 years.

The relationship between income and health in Toronto exists for a wide range of health indicators and is consistent with trends found in other jurisdictions. While the picture that emerges from the data is one of significant inequality, for reasons explained in the report, the true differences in health associated with income in Toronto are likely even greater than those documented here.

While the focus in this report is on income, health inequalities are also associated with other social determinants such as racialization, immigration and settlement status, and education. These determinants are linked to and interact with income to influence health. Evidence showing the racialization of poverty in Toronto is one important example of other related factors.

The relationship between income and health in Toronto is not just about the extremes of wealth and poverty. As the data in this report show, for most indicators there is a continuous gradient of health in relation to income - health status improves through each income increment. Toronto residents who live in high income areas are healthier than those living in middle income areas, and those who live in middle income areas are healthier than those living in low income areas. This means that health inequalities affect all Torontonians.

One way of illustrating the impact of health inequalities on the overall health of Toronto’s population is to calculate the effect if everyone was as healthy as those with the highest income and best health. Based on the methods used, this would result in:

  • nearly 1,100 (18%) fewer premature deaths;
  • about 1,300 (20%) fewer low birth weight babies;
  • about 1,600 (30%) more children ready to learn at school entry;
  • nearly 1,000 (46%) fewer teen pregnancies; and
  • more than 30,000 (about 13%) fewer male smokers.

Recent trends toward increasing polarization of income distribution in Toronto raise concerns that the health inequalities documented here may lead to a decline in the overall health status of the city’s population.

The health inequalities documented in this report should be seen as unacceptable in a society that places a high value on equal access to good health. These differences represent a missed opportunity to achieve better health for the city as a whole. The reduction of income inequality and measures to reduce poverty should be pursued as priority health strategies. Services such
as those provided by Toronto Public Health should be designed to mitigate the impact of income on health by ensuring equal access to universal services and by focusing on reaching people with greater health needs. More information about health inequalities in Toronto must be gathered and analyzed to help guide service delivery, to monitor trends, and to evaluate the effectiveness of interventions.

Changing the patterns of health and income that are described in this report is not the purview of any single agency or level of government. Toronto Public Health will advocate for urgent and comprehensive public policy responses and will collaborate with many others to continue to address the health inequalities that are linked to income and other determinants of health.

Recommendations:

1. The Medical Officer of Health report regularly to the Board of Health on key health inequality indicators for the City of Toronto;

2. The Medical Officer of Health consult with community partners and the Board of Health to incorporate appropriate strategies to reduce health inequalities in the next Toronto Public Health Strategic Plan (2010- 2014) and annual service plans, including measures to monitor progress on reducing health inequalities;

3. The Toronto Board of Health send this report to the Premier of Ontario and strongly urge the government to maintain its stated commitment to poverty reduction in Ontario as a public health measure; and

4. The Medical Officer of Health review Toronto Public Health data collection practices and collaborate with partners to strengthen the monitoring of the impact of social determinants on health, including racialization, immigration and settlement status, education and income.




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Wednesday, October 15, 2008

small steps, big difference

Welcome to small steps, big difference, a place to share thoughts, updates, information and resources related to health equity, community engagement, and change.

This blog is part of a partnership project between the Centre for Addiction and Mental Health (CAMH) and Scadding Court Community Centre (SCCC) in Toronto, Canada. The goal of our overall initiative is to develop a resource that will inspire, guide and support the planning, implementation and evaluation of equity-related change within the health sector in our region and beyond.

Our work focuses on two processes of change that are closely connected: equity-related organizational change within the health sector, and larger processes of community or social change that promote health equity. While changes within the health sector can help to address health inequities, larger social transformation is also shaped by social policy reform, socio-economic structures, economic transformation, and other forces.

Our project is grounded in an understanding that organizational change inspires, reflects, and builds on larger community or social change – small steps that can make big differences.

Through this blog, we will track our project’s development, share reflections, and post links to resources and other useful info. Our work is a process of development and growth. Please share your thoughts and resources with us so that we may learn and grow together.

Thank you for reading!
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