The Canada Health Act is supposed to be the legal and ethical framework for our “universal” health-care system. Among many other things, the act stipulates that access to adequate care will not be limited by the age, financial status or health of consumers requiring care. Admittedly, the framework is aspirational in many ways. Someone who chooses to live in Tuktoyaktuk isn’t going to have the same access to health-care services as someone who lives, say, in Hamilton.
But how can it be that someone who lives in one part of Hamilton doesn’t have the same access to adequate care as someone who lives in another part of the same city? We have a very good health-care system. We have, generally, very good doctors and all sorts of health professionals. We have a nationally leading cancer centre, teaching hospitals, state-of-the-art technology.
And yet we have this startling reality: In Ancaster, between 2000 and 2009, the cancer mortality rate was 39 deaths per 1,000 people aged 45 and older. In the lower city, bordered by Queen Street on the west and Parkdale on the east, from Main Street to the harbourfront, there were 73 deaths per 1,000 people.
Keep in mind, that’s not about getting cancer to begin with, it’s about surviving it once you’ve been diagnosed. The blunt, jarring fact is that your socioeconomic status has a great deal to do with your odds of survival. Is that what we want here in Hamilton, in prosperous and civilized Canada?
Much of what you have or will read in Cancer – A Code Red Project won’t come as a great surprise. You are probably not shocked to learn that cancer screening in less prosperous neighbourhoods is appallingly less successful than in affluent ones. You might be shocked by the extent of the disparity, but by now anyone who has been paying attention knows that poverty, education and other factors linked in the social determinants of health have an inordinate impact on the people who live with those realities.
But the information put on such harsh display in the cancer project is critical nonetheless. It quantifies what we know to be true, and using hard data and science puts it under a bright light. We cannot escape.
What do we do with this grim affirmation of what we knew to be true, but not in this graphic detail? Some of the answers should become visible as the series unfolds (it ends a week today). But there’s no easy, one-size fits all solution. Almost certainly, this is another thousand-small-solutions scenario.
One thing is clear: You can’t turn away and say this isn’t your problem. If you don’t engage because you care about human dignity and justice, you can at least engage because this disparity adds countless millions of dollars to our health-care budgets and diverts resources that could be of great benefit in more proactive ways. You really need to care about this. We all do.
— Howard Elliott, The Hamilton Spectator
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