Monday, November 07, 2005
LIVE WRITE article
Years ago, while working for the International Red Cross in Sudan, I had a memorable meeting with the Mayor of the city of Port Sudan. After sipping tea and reporting on our activities in the area, I asked, “As Mayor, if there were one thing you could do for the health of your people, what would it be?” He launched into an impassioned speech about the debilitating effects of malaria. He concluded by excitedly saying (with a grin), “Mr. Gary, if the Red Cross helps me rid Port Sudan of mosquitoes, I will build a large statue, with you bravely holding a sword up to a giant mosquito!” This was a city politician with a clear health mission. (The Red Cross did work on the malaria problem, but the St. Gary statue was never built.)
With civic elections upon us, it’s timely to think of useful questions to ask our Mayors-to-be. When asked about health issues, local politicians often point out that these are provincial responsibilities. While this is partly accurate, research on what contributes to our physical, emotional and social well-being provides a broader picture – one that shows us significant roles for local government.
Some Canadians argue that universal health care is what defines us as a people. In the CBC television series, The Greatest Canadian, it was the ‘father of Medicare’, Tommy Douglas, who garnished the most votes. With such devotion to our health care system, one might think that health, happiness and longevity depend entirely on doctors, hospitals, emergency rooms and pharmacies.
The truth is that while health services are important, they are only a part of the picture. The Canadian Institute for Advanced Research has estimated that the health care system itself contributes about 25% to your health status. Social, environmental and economic factors contribute about 60%. (The remaining 15% is based on biology and genetic endowment – and you can’t choose your parents…)
This means to foster a community of healthy people, we need to address the wider influences that lie outside the health sector. The folks you vote into local government have an important role to play.
For example, in debating zoning and growth issues, they can ask questions such as: does the development include housing for low-income people, seniors and people with disabilities? Is it accessible via all modes of transportation, including walking, cycling and public transit? What green spaces, recreational or play areas will be created? These built-in features are good for our health.
Other issues related to health that make it to the local halls of power include community safety, crime prevention and infrastructure projects such as community centres, soccer fields and libraries. Don’t forget the environment we live in - not only the obvious, such as air and water quality – but also road hazards, waste disposal and the use of pesticides. A poet (and a social researcher) will tell you that beautiful surroundings, natural and built, nurture the spirit… and the body.
Local politicians could also take on tough issues such as poverty - by developing affordable housing, supporting the establishment of a local or regional social planning council and lobbying for a living wage for all.
A sense of belonging and citizen involvement in decision-making contribute to good health. There’s a message here for local leaders - create ways to involve citizens in decision-making. You’ll be practicing wise politics... and good community health.
In political debates this month, don’t be surprised if candidates are asked about local hospitals and health services. You might also ask them how they plan to address the other determinants of health.
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