Sick and Tired


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Sick and Tired

  1. 1. Sick and Tired The Compromised Health of Social Assistance Recipients and the Working Poor in Ontario Beth Wilson, CSPC-T Ernie Lightman, SANE Andrew Mitchell, SANE
  2. 2. Overview <ul><li>Focus on the health and health care use of: </li></ul><ul><ul><li>Social assistance recipients (OW and ODSP) </li></ul></ul><ul><ul><li>Working poor </li></ul></ul><ul><ul><li>Non-poor </li></ul></ul><ul><li>Statistics Canada’s 2005 Canadian Community Health Survey - most recent, most comprehensive </li></ul><ul><li>24,464 adults in Ontario, 18-64 years </li></ul><ul><li>Low Income Measure (LIM) to measure poverty </li></ul><ul><li>Main source of household income </li></ul><ul><li>Database does not distinguish between OW and ODSP recipients </li></ul>
  3. 3. Profile <ul><li>Social assistance and working poor groups – disproportionately women, members of racialized groups, Aboriginal people and immigrants </li></ul><ul><li>Working poor - 48% members of racialized groups; 53% immigrants </li></ul>
  4. 4. Profile continued <ul><li>Median household income </li></ul><ul><ul><li>Non-poor: $80,000 </li></ul></ul><ul><ul><li>Working poor: $21,000 </li></ul></ul><ul><ul><li>Social assistance: $13,000 </li></ul></ul>
  5. 5. Major results – health <ul><li>Social assistance recipients have greatest burden of poor health and chronic conditions </li></ul><ul><li>Significantly higher rates on 38 of 39 health measures compared to the non-poor and 37 of 39 health measures compared to the working poor </li></ul><ul><li>Working poor have higher rates of poor health compared to the non-poor on many measures </li></ul><ul><li>Non-poor have higher rates of poor health compared to the working poor on some measures – healthy immigrant effect </li></ul>
  6. 9. Multivariate models <ul><li>Analyses that take into account other factors associated with health: </li></ul><ul><ul><li>Age, gender, racialized status, Aboriginal identity, educational attainment, disability status, physical activity level, smoking and employment status </li></ul></ul><ul><li>Even after taking into account all of these factors, income and social assistance receipt continue to be powerful predictors of poor health </li></ul>
  7. 10. Food insecure households <ul><li>Social assistance: 49.3% </li></ul><ul><li>Working poor: 16.5% </li></ul><ul><li>Non-poor: 3.2% </li></ul>
  8. 12. Major results – health care use <ul><li>Social assistance recipients and the working poor are less likely to have a regular medical doctor compared to the non-poor </li></ul><ul><li>Social assistance recipients have more consultations with medical practitioners of all kinds compared to other two groups </li></ul><ul><li>Working poor have more consultations with general practitioners but less with specialists compared to non-poor </li></ul>
  9. 13. Preventative health care <ul><li>Working poor less likely to have ever had eye exam or visit to dentist or to have a recent visit to either </li></ul><ul><li>Working poor and social assistance groups have much lower rates for women’s preventative health </li></ul>
  10. 14. Health insurance <ul><li>Working poor much lower rates for health insurance – prescription meds, dental, vision – compared to other groups </li></ul>
  11. 15. Unmet health care needs <ul><li>26.3% social assistance recipients </li></ul><ul><li>15% working poor </li></ul><ul><li>12.5% non-poor </li></ul><ul><li>Cost is reported as a reason for 20-22% from poor groups with unmet health care needs compared to 9% non-poor </li></ul><ul><li>Transportation another factor for poor groups </li></ul>
  12. 16. Recommendations <ul><li>Improving the provincial poverty reduction strategy </li></ul><ul><ul><li>Expand provincial target to reduce poverty by 25% in 5 years for ALL Ontarians </li></ul></ul><ul><ul><li>Independent panel to set OW and ODSP rates to reflect cost of living, evidence-based process </li></ul></ul><ul><ul><li>Live up to UN commitment to human right to food </li></ul></ul><ul><ul><li>Review ODSP access/barriers in social assistance review </li></ul></ul><ul><ul><li>Update employment standards </li></ul></ul><ul><ul><li>Set minimum wage above the poverty line </li></ul></ul>
  13. 17. Recommendations continued <ul><li>Taking Action on the Federal Level </li></ul><ul><ul><li>Introduce national poverty reduction plan with concrete targets and timelines </li></ul></ul><ul><ul><li>Restore Employment Insurance as a universal program for unemployed workers </li></ul></ul>
  14. 18. Recommendations continued <ul><li>Improving Health Care Access, Promoting Health Equity </li></ul><ul><ul><li>Areas for action: CHC funding; dental, vision, drug coverage; Ontario Trillium Drug Plan; language interpreter services, health ambassadors </li></ul></ul>
  15. 19. Many thanks <ul><li>Co-authors: Ernie Lightman, Andrew Mitchell </li></ul><ul><li>Research partner: Michael Shapcott, Wellesley Institute </li></ul><ul><li>CSPC-T Communications Officer: Christopher Wulff </li></ul><ul><li>Research assistance: Raluca Fletcher, Esther Guttman, Zak Tucker-Abrahamson </li></ul><ul><li>Research advisory committee members </li></ul><ul><li>Funders: Wellesley Institute, SSHRC, City of Toronto, United Way Toronto </li></ul>