Stating that “poverty makes people sick,” the CMA is urging Parliament to respond to the stress that poverty places on the health care system.

Dr. Anna Reid, addressing the All-Party Anti-Poverty Caucus (APAPC) June 4, urged them to weigh the “social determinants of health.”

The CMA president told about a dozen MPs and senators that poor people have a lower life expectancy and a higher disease rate than wealthy people. They also have higher rates of hospitalization and mental health admissions “which could potentially be avoided with proper primary care,” she said.

Twenty per cent of health-care spending goes towards care for illness and disease that can be attributed to low income and poor housing, she said.

Reid spoke of her experience in Yellowknife where many of her patients have diabetes or pre- diabetes but no money to buy nutritious food. They are worrying about where to sleep and what to eat, she said. “There is no way they can properly manage diabetes.” The circumstances of one’s day-to-day existence determine whether someone is healthy or sick, she said.

She urged that governments pay greater attention to the “upstream factors” that affect health.

The poor are the most in need of good health care but least likely to have access to either primary care physicians or specialists, she said. They are also less likely to have access to pharmaceuticals not covered by the public health system.

In town hall meetings conducted across the country since February, the CMA kept hearing Canada cannot have a healthy population without eliminating poverty, Reid said. She cited a Hamilton, Ont. study that indicated residents in a wealthy neighbourhood had a life expectancy of 83 compared to 62 for those in the lowest income neighbourhoods.

“Adverse socio-economic conditions in childhood can be a greater predictor of cardiovascular disease and diabetes in adults than later-life circumstances and behavioural choices,” she said. “Countries reporting highest population health status are those with the greatest income equality, not the greatest wealth,” she said.

Among seven recommendations the CMA has proposed are the creation of a prescription drug strategy to ensure the 10 per cent of Canadians who lack access to prescription drugs can get them. They are also want low- income Canadians to have better access to rehabilitation, mental health, home care and end-of- life care.

The CMA also recommended that options such as public insurance or registered savings plans be explored to fund long-term care services. Additionally, it wants to see expansion of relief programs for informal caregivers such as family members caring for aging parents or disabled children.

As a top priority, the CMA wants the federal government to develop strategies to minimize poverty in Canada.