Poverty, inadequate housing, the need for proper nutrition and the importance of early childhood development - all of these social determinants of health were mentioned in St. John's on June 3 in the last of a series of 2013 town-hall meetings organized by the CMA as part of its health care transformation initiative.
While all these issues had been raised at earlier meetings, participants at this town hall provided a local flavour to the challenges and possible solutions. One example concerned the need to find healthy and affordable food, an issue raised throughout the evening.
"This town hall is special in that the demand for it came directly from the St. John's community," said CMA President Anna Reid. The CMA joined with the Newfoundland and Labrador Medical Association (NLMA), the Newfoundland and Labrador Housing and Homelessness Network and Memorial University's Harris Centre to organize the meeting.
NLMA Past-President Sandra Luscombe and meeting moderator Anthony Germain, host of The Morning Show on CBC Radio in St. John's, both noted that the recent prosperity experienced in Newfoundland and Labrador has heightened social and economic disparities.
Germain said major housing issues have emerged, particularly in St. John's, with costs rising while the available stock of properties remains limited.
Panellist Bruce Pearce, community development coordinator for the St. John's Community Advisory Committee on Homelessness, contrasted the sudden tragedy of witnessing 10,000 people left homeless after the St. John's fire in the 19th century with the "smouldering" issue of having 1,500 people using homeless shelters in St. John's today.
Other panellists were Peter Jackson, commentary editor for The Telegram; Dr. Cheri Bethune, a family physician at the Shea Heights Community Health Centre who teaches at Memorial University; and Heather Bartlett, executive director of the Daybreak Centre.
Bethune noted that she has two roles: to act as advocate for every one of her patients, and to serve as a sentinel who spots emerging problems in her community. Reid said physicians who act as sentinels can play a key role in making policymakers aware of new issues.
Bethune said physicians and nurses in Newfoundland and Labrador have to be comfortable working in rural communities, where many disadvantaged people live. She said the education system needs to be adapted to give providers the resources required to deal with these issues.
Pearce drew the night's loudest applause by calling on the provincial government to pass legislation to address poverty, as has been done in New Brunswick.
In addition to hearing concerns directly from about 100 people who attended the meeting, the town hall was webcast live to groups of students in Carbonear and Happy Valley-Goose Bay, who also contributed to the discussion.
The St. John's town hall supplemented five held across Canada earlier this year, which were co-sponsored by the CMA, Maclean's and CPAC.
The CMA will use feedback provided during the town halls and on an online forum on one of its websites (www.healthcaretransformation.ca) to provide guidance as it compiles a report on future steps in the transformation process.