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