Your vote is a health-care decision

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Dispatches from the 148 by Fred Ryan

I started this column with the idea that there’s a personal component to our health, independent of the health care system with its professionals and facilities. No rocket

Dispatches from the 148 by Fred Ryan

I started this column with the idea that there’s a personal component to our health, independent of the health care system with its professionals and facilities. No rocket
science here with smoking, drinking, body weight, activity, mental stimulation, and so on – studies have shown these personal factors play a huge role in our health, whether we live next to a mega-
hospital or on a First Nations reserve.
To bolster this suggestion that we need to look in the mirror as much as to Quebec City’s budgets when we pass judgement on public health, I retrieved the twelve “health outcome determinants” of Dr Vander Stelt, from the hospital in Shawville. I realized I was wrong.
Of her twelve determining factors, ranked in order of influence, the actual health care system itself comes in at number 10.  Not number one, as many think.
However, of the remaining eleven, only two or three are related to our personal habits (smoking, eating, drinking, etc.) 
Two-thirds of the health condition determinants
in Canada are social,
political, and cultural.  That is surprising.
Dr Vander Stelt’s list: number 1: income and social status. (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 itself; 11: our sex or
gender, and 12: our cultural practises.
This means – statistically speaking – we could live beside a magnificent and accessible health facility, we could eat only the healthiest of foods, avoid alcohol and nicotine, exercise every day, be careful in our habits, etc. – and still end up with terrible health.  This happens – celebrity health advocates, runners, etc. regularly drop dead in the prime of life. Not all, but enough to give us pause.
The pause is so we can look at these dozen health determinants, and realize that the majority are
political and social, not personal or infrastructural.
The best things we can do to stay healthy, the
list implies, are to get involved with political and social movements around improved wages, especially minimum wage, availability of jobs, improved
working conditions, better and more education, early child care, and the improvement of oppressive cultural practises and prejudices.  There’s little we can do about genetic load, or gender, except to be aware of their effect.
There’s plenty here, for all personalities and interests.  What’s also important is that better wages and better schools and income inequality are not mere “political questions”, they are health questions, hence life-and-death questions. 
In the election coming this fall, shouldn’t our questions and our votes target these issues – assuming our own health care is of utmost importance (over expensive
military adventures, for example)?
Yes, better health is not a single-cause goal; we have to be health
conscious in our personal habits – a responsibility that’s ours alone—but we have to pay attention to and get involved in
making our whole society “healthier” – a society that’s more equal, more stimulating, more supportive,  less depressing, and less competitive.
That said, we still must get rid of seven-hour wait times in ER. But the political route to all these goals, even to better eating, is unavoidable.  It’s political.