I'm very pleased to bring the Canadian Medical Association's perspective on income inequality to your committee.
You may wonder why the CMA, which represents over 78,000 physician members, is actually concerned about income inequality. We know that every day, patients with illnesses of every kind crowd our clinics and our hospitals. When we look at the health outcomes of these patients, we find that only 25% are determined by the health care system. Another 25% are determined by biology and genetics.
Having a much greater impact are such factors as the state of a person's housing, whether they get enough to eat, how educated they are, and what kind of experiences they had in their early childhood. These social determinants of health in fact account for 50% of the health outcomes.
The most influential of these determinants is income. We know that if you're rich in Canada, you will be healthier than if you are poor. The poor experience higher rates of suicide, mental illness, disability, cancer, heart disease, and chronic illnesses such as diabetes. We know that the poor are 1.9 times more likely to be hospitalized. The poor are three times less likely to fill prescriptions and 60% less able to get needed tests because of cost. The poor live shorter lives. Poverty in childhood can be a greater predictor of cardiovascular disease and diabetes in adults than later life circumstances and behavioural choices.
There's a cost to this poverty and the disparity between the rich and the poor. The poor tend to consume more health care services than those of higher socio-economic status. According to one estimate, about 20% of total health care spending in Canada can be attributed to income disparities alone. A study done in 2011 by the Saskatoon Poverty Reduction Partnership found that over the course of a year, low-income residents consumed $179 million more in health care costs than middle-income earners.
While economics are important, so too are fairness, dignity, and compassion. Canada's doctors are concerned that as a nation we are not doing enough to address these factors.
Among the CMA's recommendations, we suggest that as federal departments develop new policies, they put them through the test of a health impact assessment to evaluate the potential effects on the health of Canadians. Under such a process, greater scrutiny might have been accorded to changes to the qualifying age for old age security and to new rules for employment insurance, both of which will have far-reaching consequences on some people's incomes. Every action that has a negative effect on health will lead to more costs to society down the road.
But it's not just about what we doctors think. The CMA has been conducting a series of public town halls around the country asking Canadians about how the social and economic conditions of their communities affect their health. We've gone from Calgary to Hamilton to Charlottetown, as well as online, and we're hearing how low incomes are undermining Canadians' health.
This public response is really not surprising. According to the Conference Board of Canada, more than one in seven children in Canada live in poverty. And let there be no doubt—this poverty will limit the ability of these children to live lives that are as long and healthy as children who come from wealthier families. Success in ameliorating seniors' poverty is acknowledged as one of the great policy achievements of recent decades. Building on that success, the federal government should explore and establish programs that eliminate poverty for all Canadians.
In conclusion, the CMA commends this committee for studying this very important issue. Income inequality matters to physicians, because it translates to health inequity. That runs counter to everything that we've been taught to believe as physicians and that we work towards achieving.
It's worth noting that countries reporting the highest population status are those with the greatest income equality, not the greatest wealth. Canada's a wealthy country, and there's no reason why it cannot have greater income equality too.
Greater income equality can reduce the burden of disease in Canada, lessen the pressure and costs on our health care system, and help ensure that every Canadian has a chance to be a productive, contributing, and healthy member of society. Canada's physicians believe that every Canadian deserves a chance to live a healthy life, and I believe that how well we are able to achieve health equity for our citizens should be a measure of the humanity and soul of our nation.
Thank you very much.