Social and Economic Determinants of Health

alPHa Position

alPHa agrees with the statement by Canada's former Minister of State for Public Health, that "poor living conditions such as poverty, food insecurity, family violence, inadequate housing, unsafe environmental conditions, social discrimination, poor working conditions and lack of education...are often the root causes of poor health." alPHa believes that health inequalities due to these factors are measurable and that clear cause-and-effect evidence exists to inform interventions to reduce preventable illness and premature death.  

Open Resolutions

#A05-4, Determinants of Health as a Mandatory Public Health Program 
#A05-18, Adequate Nutrition for works and Ontario Disability Support Program Participants and Low Wage Earners
#A02-10, Aboriginal Public Health in Ontario
 

Closed Resolutions

#A05-19, Tax Relief for Families with Children Living in Poverty 
#A01-19, Ontario Works Allowances and Adequate Nutrition

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RESOLUTION	RECENT DEVELOPMENTS
#A05-4, Determinants of Health as a Mandatory Public Health Program  NOW THEREFORE BE IT RESOLVED THAT the Association of Local Public Health Agencies (alPHa) request that the Mandatory Health Programs and Services Guidelines be revised to include the Determinants of Health as a recognized health program and service area and planning framework for all Ontario boards of health	February 19, 2007 Ontario Public Health Standards Draft for Consultation released. SDOH is not a separate program. Please see alPHa’s response to the consultation November 20, 2006 alPHa has received a reply from Program Standards Review Committee co-Chair George Pasut to the letter described below. Please click here to read. October 3 2006 alPHa has sent a letter to the co-chairs of the Program Standards Review Committee to introduce this resolution, supported by the Discussion Paper described below. Please click here to read. March 2006 The Subury and District Health Unit has led a process to explore the rationale and the means to integrate social and economic determinants of health into the Ontario public health mandate. With input from a wide range of public health stakeholders throughout the province, the SDHU has released a Discussion Paper on the subject. It argues that public health is in a position to lead efforts to improve health status through new determinants of health mandates that should be added to the public health roster during this time of transformation. Please click here to read the discussion paper. December 15, 2005 alPHa has sent a letter to the Minister of Health and Long-Term Care introducing the Resolutions passed at the 2005 Annual General Meeting for follow-up and action by his Ministry. Please click here to view the letter.
#A05-18, Adequate Nutrition for works and Ontario Disability Support Program Participants and Low Wage Earners  This resolution calls for immediate increases to provincial social assistance rates and minimum wages in order to ensure adequate nutrition. Please see A01-19 Below for further history on this subject.	September 25, 2007 alPHa has sent a letter to the leaders of Ontario's major political parties to request statements on how they will use the Cost of a Nutritious Food Basket data, collected by all health units each year, to determine adequate social assistance and minimum wage rates. The letter includes alPHa's 2007 survey of health units on their individual survey results, which clearly illustrates that the cost of healthy eating has been steadily rising throughout Ontario since at least 2003, with an average increase of about 3.3% since 2006. Some health units have reported increases significantly higher than this. Please click here to read the letter  April 25, 2007 alPHa has received a reply to the April 12 letter to the Premier. Please click here to read. April 12 2007 alPHa has sent a letter to the Premier of Ontario in support of the Toronto Board of Health Report, Impact of Poverty on Children's Current and Future Health, which includes advocacy for the increases described in Resolution A05-18. Please click here to read the letter. Please click here to read the Toronto Board of Health Report, Impact of Poverty on Children's Current and Future Health April 12 2007 alPHa has forwarded this Resolution to the Minister of Finance as part of a response to the measures announced in the March 2007 Ontario Budget. Please click here to read the letter. March 19 2007 The March 19 2007 federal budget included a $2000 annual tax credit for each child under 18, which will apply to all families, and result in the further exemption of approximately 180 000 low-income families from the tax roll December 11 2006 alPHa President Liana Nolan made a presentation to the Minister of Finance during the 2007 Budget consultation, which included urging specific consideration of the operative clause of this resolution. Please click here to read the speaking notes May 15, 2006 The final report of the Task Force on Modernizing Income Security for Working-Age Adults (MISWAA) is released. While it does not make the call for immediate and substantial increases to social assistance rates and minimum wage, it makes strong statements about their inadequacy. 14 recommendations are aimed at the federal and provincial governments to strengthen income security. Please click here to read the report. April 5, 2006 Endorsement of alPHa Resolutions A05-18 and A05-19 received from the Ontario College of Family Physicians. Please note that this correspondence was sent to the Federal Minister of Health and the Provincial Ministers of Health, Children and Youth Services, Health Promotion and Community and Social Services. Please click here to read. February 15, 2006 Response received from the Minister of Community and Social Services outlining the recent changes to Ontario Works and ODSP, explaining the new restrictions on the Special Diet Allowance and referring to the Review of Employment Assistance Programs in Ontario Works and Ontario Disability Support Program. Please click here to read the response. February 2 2006 Response received from the Minister of Labour indicating that increases to the minimum wage beyond those already planned would require renewed consideration by the government. Please click here to read the response. January 9, 2006 Letter written to Minister of Community and Social Services Sandra Pupatello and Minister of Labour Steve Peters introducing this resolution. Please click here to read. December 1, 2005 alPHa circulated a news release to all of its members for distribution to local media outlets informing of the passage of this Resolution. Please click here to read. Nov 21, 2005 Please see the Toronto Board of Health Report calling for immediate increases to social assistance rates. It contains a wealth of statistics that illustrate that the purchasing power of OW recipients has steadily and significantly declined since 1995.
#A02-10, Aboriginal Public Health in Ontario The opererative clause, passed in 2002, of this resolution recommends and urgently requests that a comprehensive review and consultation process, to include First Nations representatives, senior federal and provincial health ministry representatives, municipal government representatives, alPHa and Boards of Health representatives, be initiated by the provincial and federal government for the purpose of: Clearly determining an Aboriginal Public Health system in and for Ontario First Nation citizens; Developing, resourcing and staffing an Aboriginal Public Health Resource centre; Establishing methods of funding, reporting and evaluating such systems so as to guarantee the equitable and quality delivery of all aspects of the Health Protection and Promotion Act and its Regulations to all First Nation citizens of Ontario while maintaining fiduciary responsibility of the Federal government in accordance with the Canadian Constitution (British North American Act) and Treaty rights of First Nation Citizens.	December 12, 2007 alPHa has written a letter to the new Minister of Aboriginal Affairs to make him aware of this resolution and some of the progress that has occurred thus far, and invite further discussion about the role of the new Ministry. Please click here to read. October 2007 alPHa is participating in a meeting organized by the Ontario chiefs of first nations communities on October 25th and 26th to review public health strategies for their communities. alPHa is also organizing a day-long session on public health and First Nations for its annual winter meeting, to be held February 8th 2008.   November 2005 The "Blueprint on Aboriginal Health: A 10-Year Transformative Plan" was prepared for the Meeting of First Ministers and Leaders of National Aboriginal Organizations. The governments of Canada, each of the provinces and territories along with the Canada Assembly of First Nations, Ontario Congress of Aboriginal Peoples, Québec Inuit Tapiriit Kanatami, Nova Scotia Métis National Council and New Brunswick Native Women’s Association of Canada contributed to this plan. Click here to read the plan. September 30, 2005 alPHa has received communication from the Chief Medical Officer of Health providing a summary of key findings from a survey of public health stakeholders regarding the development of concrete initiatives on Aboriginal health. Gathered from responses to a memo she issued in June of 2005, it is anticipated that they will provide focus for needs and priorities as the provincial component of the national Aboriginal Health Blueprint is developed. Please click here to read the cover letter. Please click here to read the Summary of Responses from Public Health Stakeholders January 24, 2005 alPHa has sent a letter to Minister of State (Public Health) Carolyn Bennett to follow up on two resolutions, one of which is specific to the province's role in providing funding for speech language and audiology programs in general, with a view to extending them into aboriginal communities. This was used as an example to inquire about the new federal agency's role in First Nations public health matters. Please click here to read the letter. January 30, 2004 Jo-Anne Miller, Provincial Program Manager, Ontario Aboriginal Health Advocacy Initiative (OAHAI), gave a presentation titled, Aboriginal Access to Health Care Systems, at the alPHa 2004 All Members' Meeting. This presentation discussed the Aboriginal Healing and Wellness Strategy, which includes programs and services ranging from community wellness workers to information clearinghouses. A discussion was also held about the work done in 1994 to develop the Aboriginal Health Policy to help the Ministry of Health address the inequities, poor health and poverty of Ontario's Aboriginal people. Based on principles of holistic health and partnership, the Policy provides for strategies on health status (healing and wellness programs, health empowerment, equitable funding), access to services (language, transportation, health worker recruitment), and planning and representation. Underlying many of these strategies is the need to respect traditional native approaches and values to health. To view the presentation click here. October 29, 2003 alPHa staff has invited staff of the Ontario Aboriginal Health Advocacy Initiative to present at the January 29-30, 2004 All members Meeting.  The purpose of this presentation will be to introduce some of the most pressing public health issues facing Aboriginal, First Nations and Metis people  and open a dialogue with local public health agencies on how they could be addressed. Read the original letter of request by clicking here. February 7, 2003 Response received from Geoff Kettel at the Public Health Branch (PHB) indicating that "there are ongoing discussions between the Ministry of Health and Long-Term Care and Health Canada regarding a coordinated approach to the delivery of health services for the Aboriginal community". September 19, 2002 Letter received from Robert Nault, federal Minister of Indian Affairs and Northern Development, applauding alPHa's efforts in this regard, further indicating that the mandate to provide such services is held by Minister of Health Anne McLellan.

CLOSED RESOLUTIONS

#A01-19, Ontario Works Allowances and Adequate Nutrition The operational clause of this resolution passed in 2001 states that the Government of Ontario is urged to review and ensure that the Basic Allowance portion of Ontario Works Financial Assistance allows for adequate nutrition.

February 1 2007 Resolution closed by alPHa Board of Directors January 11 2006:  The alPHa Advocacy Committee agreed that Resolution #A05-18, Adequate Nutrition for works and Ontario Disability Support Program Participants and Low Wage Earners adequately accounts for the intent of this one and that any further advocacy would be based on its operative clauses. June 15, 2005 alPHa has received a detailed response to the concerns raised about Ontario Works benefits in the January 31 letter. Please click here to read. April 01, 2005 alPHa received a response to the letter below. Please click here to read. January 31, 2005 alPHa has sent a letter to Minister of Children and Youth Services, introducing these and one other resolution. Please click here to read the letter. April 23, 2004 Response to March 23rd letter received from Minister Pupatello with items on skills training, affordable housing, and top-ups for special dietary needs. Please click here to read. March 23, 2004 Letter sent to Community and Social Services Minister Sandra Pupatello reintroducing Resolution A01-19 and congratulating the government for scrapping the lifetime ban for welfare fraud. Please click here to read. January 9, 2004 Formal announcement of the end of lifetime ban and three / six month suspension policies made by Social Services Minister Sandra Pupatello. Click here to read the news release.   December 17, 2003 Social Services Minister Sandra Pupatello promises to abolish the lifetime ban from social assistance of anyone convicted of welfare fraud, as well as to raise social assistance rates, though no details are offered.   March 28, 2003 alPHa member, Porcupine Health Unit, passed resolution in support of #A01-19 calling for a review of the basic allowance of Ontario Works Financial Assistance to ensure recipients meet adequate nutrition needs and that the province provide funding to families ineligible to receive social assistance due to fraud conviction to help them meet nutritional and accommodation needs.

#A05-19, Tax Relief for Families with Children Living in Poverty This resolution urges that any tax changes contemplated during the 2006 federal election campaign include, as a first priority, a significant, non-refundable tax credit to be paid poor families with children

April 27 2007 Resolution closed by alPHa Board of Directors April 24 2007 alPHa Advocacy Committee recommends closure of resolution, as it was aimed at candidates prior to the last federal election and not because of any opinion about the adequacy of tax measures recently announced. March 19 2007 The March 19 2007 federal budget included a $2000 annual tax credit for each child under 18, which will apply to all families, and result in the further exemption of approximately 180 000 low-income families from the tax roll December 11 2006 alPHa President Liana Nolan made a presentation to the Minister of Finance during the 2007 Budget consultation, which included urging specific consideration of the operative clause of this resolution. Please click here to read the speaking notes April 5, 2006 Endorsement of alPHa Resolutions A05-18 and A05-19 received from the Ontario College of Family Physicians. Please note that this correspondence was sent to the Federal Minister of Health and the Provincial Ministers of Health, Children and Youth Services, Health Promotion and Community and Social Services. Please click here to read. Jan. 4, 2006: alPHa has sent a letter to each of the major federal party leaders’ headquarters introducing this Resolution. Please click here to view the letter.