Spend on social services, save on health care, says new Saint John doc

You may have heard the old saying, "An ounce of prevention is worth a pound of cure."

A new Saint John doctor and medical educator says the same holds true for spending on social services.

"Spending on social services tends to have a larger impact on gigantic health outcomes, such as dying, versus spending on health care," said Dr. Daniel Dutton, the newest addition to the instructional staff at Dalhousie Medicine New Brunswick.

"In Canada, we spend a gigantic proportion of our money ... on health care, which ends up being treatment of diseases.

"And in medical education, we understand that the social determinants of health — things like income and education, the environments in which people live their lives — are very important for the eventual health outcomes people experience."

Dutton works in public health and epidemiology and has just started at the Saint John Medical School.

He previously worked at the University of Calgary, where he led a study on the effect of provincial social services and health spending on health outcomes. It was published in the Canadian Medical Association Journal in January 2018.

The researchers looked at 30 years worth of budgets in nine Canadian provinces. They found health-care spending doubled per person over that time, with no commensurate gains in health outcomes. 

When it comes to social programs, on the other hand, Dutton said spending an extra penny for every dollar spent on health care, can improve health outcomes by five per cent.

"We know that programs like guaranteed annual incomes, such as the old age security payments, have a phenomenal effect on the health of seniors and we know that housing has an important effect on people's health," he said.

"You see all sorts of studies that say things like... if only people exercised more or if we guaranteed people money such that they didn't experience food insecurity. 

"These are the kind of things that we know have health benefits and those are the kinds of things that increased social spending, in turn, affects."

Dutton said he thinks the political will exists to address generational and chronic poverty in Saint John.

"I've noticed that at all three levels of government in New Brunswick, you have a unique situation where it seems that everyone is on board with addressing the evident issues that the city is facing," he said.

The challenge will be to see that translate into budget decisions.

"We know how to mitigate some factors," he said. "For example, housing quality, food insecurity, access to food. These are things that we know how to solve."

Randy Hatfield of the Saint John-based Human Development Council said housing and food security "continue to be real challenges for a large cohort of the population."

"We know there won't be a serious decline in poverty until we're able to put more money in the hands of low-income people," he said.

Hatfield is in favour of increased social assistance rates and higher minimum wages, but he acknowledged income is not the sole measure of poverty.

He also supports preventative health care initiatives, new child-care subsidies and affordable education.

The provincial co-ordinator of the New Brunswick Common Front for Social Justice agreed higher basic social assistance payments are needed, along with investments in social housing.

Jean-Claude Basque said Dutton's research supports one of the things that group has always said.

"If you reduce poverty, it will have a direct impact on people's lives and improve health outcomes," said Basque.

Basque said there would be savings in other departments as well, such as justice, if poverty was reduced.