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Being poorer, dying faster: it's time to end Canada's "national disgrace," CMA says

The CMA kicked off a new round of cross-Canada town-hall discussions in Winnipeg Feb. 4, and the sessions will all focus on factors outside the health care system that have a profound impact on people's health.

The 2013 town halls are the result of an ongoing partnership among the CMA, Maclean's and CPAC. The first meeting in Winnipeg focused on factors that cause poor health outcomes among Aboriginal Canadians. These issues, such as poverty and inadequate housing, have resulted in far lower life expectancy than in the rest of the population.

The Winnipeg town hall, which will be followed by similar meetings in Charlottetown, Calgary, Hamilton and Montreal, marked the next phase in the CMA's ongoing health care transformation initiative. The goal is to ensure that Canadians have a voice in reshaping the health care system.

At a news conference announcing this year's town halls, CMA President Anna Reid said it was both considerate and economically logical to tackle the factors behind the high demand for health services. She pointed out that an estimated 20% of the $200 billion Canada spends on health care each year can be attributed to socioeconomic disparities.

"Physicians are not experts in adequate housing or early childhood education, but we are experts in dealing with the negative downstream outcomes of these and other issues," said Reid. "The CMA is going out to Canadians to learn how we can try to head off these problems upstream."

Reid said many groups are already striving to address these core issues, and Canada's physicians "want to do our part - we want to lend our voices to raising awareness, help foster the discussion and listen to what Canadians have to say."

The Winnipeg town hall attracted almost 200 people. It focused on four areas: the impact social determinants have on health, ways to offset this impact, the things governments and health care providers can do to help, and ways to ensure equitable access to health for everyone.

Reid was joined on the town-hall panel by Dr. Barry Lavallee, a family physician and member of the Saulteaux and Métis communities in Manitoba, Chief Donovan Fontaine of the Sagkeeng First Nation, Winnipeg activist Kathy Mallett and Maclean's Ottawa Bureau Chief John Geddes.

During the discussion, Reid touched on her own work as an emergency physician in Yellowknife, where she sees many Aboriginal patients whose poor health is a result of poor housing and nutrition, as well as inadequate income and education. She called the situation "a national disgrace."

Moderator Ken MacQueen, the Vancouver bureau chief at Maclean's, said that although some may consider any discussion of social determinants a "politicization" of health care, "governments come and go, but social, economic and health divides remain decade after decade."

Fontaine and Lavallee spoke at length about what they see as the structured racism inherent in Canadian society and its impact on Aboriginal people's ability to gain a proper education and achieve good health.

The discussion emphasized the complexity and entrenched nature of the issues Aboriginal people will face in their efforts to overcome socioeconomic barriers.

Reid said the Winnipeg discussion convinced her that poverty is the major issue that will have to be addressed if progress is to be made in improving health outcomes for Aboriginal people.

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