Our health outcomes are not all set in Quebec City

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Dispatches from the 148 by Fred Ryan


Dispatches from the 148 by Fred Ryan

Back in the day, a simple slogan powered the struggles for women’s rights : “Our bodies, our selves.” Simple and persuasive. Maybe we should bring it back today, not only for women’s struggles, but for us all in our modern day struggle for health care. A complementary slogan is “health care begins at home”. Our eating, sleeping, and entertainment affect our health immensely. We can’t ignore our personal role in our health state.
Five years ago, complaints about the health system ranged from
doctors too busy to listen and to take second looks to care facilities lacking equipment, supplies, or staff. Our problems, in this context, were with “them”. The “them”: everyone from politicians meddling in health-care politics to professionals not doing their job, from deadening bureaucracies to insufficient technologies or
supplies: them, not us.
We may be the consumers of health care, but we are also the causes of health problems, in most cases.
This situation has worsened, thanks to the “austerity” stupidities of our compromised political leaders. Budget cuts and forced mergers to fit the bureaucratic agendas of Quebec City and Ottawa (and Bay Street) – but not our life-agendas – are the problem.
And so here we are, stuck between a rock and a health crisis. The story doesn’t end here. The rock here is in that second slogan: health care begins at home.
Dr Vander Stelt, at the Shawville hospital, has made it clear that “health outcomes” are not based solely on medial facilities and services.  She has
quoted studies of what does affect our health care, and those surveys are very informative. Of the top dozen determinants of anyone’s health condition and care, only one, number 10, has to do with the health system itself.
So, according to the doctor’s information, when we complain that a service is not available in a timely way or that we were mis-diagnosed or mis-prescribed, we are focusing on one of the least important determinants of our personal health. This
doesn’t mean that Quebec City is free to cut health care funding further. It means that you and I have a much larger role to play in our health and our life expectancy than we are willing to admit – or accept.
What does affect our health and health care? Number 1: income and social status. That’s right, the wealthier you are, in our equalitarian society, the better your health care will be; 2: our social support networks; 3: our education and literacy; 4: our careers and jobs (and their working conditions). 
Next up: 5 & 6: our social and physical environments; 7: our health habits (get check-ups, eat carefully, avoid toxins –nicotine, alcohol, etc).
8: early childhood development – what we were fed, how we slept, were treated, etc. 9: biological and genetic heritage. 10: the health care system; 11: our sex or gender, and 12: cultural practises.
How interesting that obesity, smoking, lack of exercise, depression and lack of self-respect are not THE determinants of our general condition as much as the more intangible factors.
In fact, according to this survey, we would be more successful in creating good public health by improving wages, minimum wages, availability of jobs, working conditions, education, and other social conditions. Not much we can do about genetics, except to be better aware of their burden (or benefit).
We are always recreating our society. The policies and parties we support will have as much to do with out personal health as will our family doctor.