Federal funds must fix social issues to improve health, says architect of N.L.'s Health Accord
Fixing problems like poverty will do more to improve health outcomes long-term, says Sister Elizabeth Davis
One of the leading forces behind Newfoundland and Labrador's 10-year health-care plan says new federal funding will help implement about half of their plan — but nothing will succeed without finding ways to address the other half.
Sister Elizabeth Davis, who co-chaired the team that produced the Health Accord, said the money — which includes an immediate $100 million per year increase in health funding from Ottawa — can address crises in emergency departments and surgery backlogs right now.
But she's urging the federal and provincial governments to consider the larger societal problems outlined in the 266-page document she produced.
"These things are immediate and have to be addressed," Davis said Tuesday. "But if you address them alone, you're not really going to really effect any real change in health outcomes. So how do you mix responding to the emergency issues, if you want to put it this way, with fundamentally changing how we approach those issues? Getting that balance is going to be very important."
Davis said she's glad to see the majority of the money — $850 million — will be provided through bilateral agreements, in which the federal government will have stipulations attached and will monitor how the money is spent.
She sees four areas in which those bilateral agreements overlap with the recommendations in the Health Accord: increasing health funding, addressing specific shortcomings in the health-care system, acknowledging Newfoundland and Labrador has unique challenges related to geography and population, and modernizing health data.
She said key issues that can be addressed through the new federal funding are elderly care, Indigenous health, community care, mental health, long-term care, home care, and recruitment and retention of health workers.
Davis also agrees with the principle of a bilateral agreement when providing funding.
"The federal government says the provincial government has to be accountable to the federal government," Davis said. "What the Health Accord says is that the provincial government has also to show its accountability to the people of the province, and the people of the province have to show their accountability for their part of this."
Poverty reduction crucial
While Davis said the funding will address half the recommendations of the Health Accord, she said the other half — which addresses the social determinants of health — is perhaps more important and needs even more attention.
One of the findings of the Health Accord is that social, economic and environmental factors play a role in 60 per cent of health outcomes, while the actual health-care system accounts for 25 per cent, and a person's genetics make up the final 15.
It also found the province increased health spending by 232 per cent in the past four decades, while social spending increased only six per cent.
Davis said the true changemaker for Newfoundland and Labrador's health-care system will be increasing funding to reduce issues like poverty.
"As long as we have high levels of poverty; as long as we have mental health issues not being addressed at a fundamental level, not just being reacted to when an acute episode happens; as long as we don't invest in children early; as long as we don't have age-friendly communities, we're not going to change health outcomes," she said.
With files from The St. John's Morning Show