Canada invests a lot in children’s recovery from illness but not enough in their ongoing health, according to health-policy consultant Steven Lewis. The Saskatoon-based analyst, who is also an adjunct professor at SFU, will make his case at an upcoming talk that he hopes will help prompt business, government, and public leaders make urgent changes—without which our kids and our economy will suffer.
“Canada is a generous society in terms of health care, and if you’re a child with an acute condition, you’re going to get as good care as anywhere in the world,” Lewis tells the Straight on the line from his Saskatchewan office. “But on the children’s-development side, how do we as a nation do in, say, eliminating child poverty and in making sure all kids have a good start in life, social support, and high-quality childcare? When it comes to social investment in children and their families, we’re not so good.
“And this isn’t good for kids and it’s not good for the economy or society as a whole.”
Lewis, who will be speaking in Vancouver on May 23 as part of the SFU Children’s Health Policy Centre’s annual Mowafaghian visiting scholar program, notes that although income disparities in Canada haven’t reached the same levels as those in the United States during the past several years, they still represent a “worrisome” trend.
“Certain neoconservative trends seep their way into Canada, and some children are among the victims,” he says. “We need to revisit our overall policy in the sense of where we distribute our social capital. We are so heavily focused on downstream health care that I think we have neglected the broader social investments and determinants of health….We have…taxes to repair physical infrastructure but we keep incurring these long-term liabilities and don’t make sound, up-front investments which would eliminate the need for future expenses, like incarceration.”
As an example of the way governments throw huge amounts of money at megaprojects that focus on treating illness but find it harder to support smaller, more sustainable grassroots-type initiatives that focus on prevention, he points to a situation unfolding in Saskatoon.
There, the previous provincial government had set aside $8 million in funding for an integrated health centre that would serve a poor area of the city, Lewis says; the new government pulled the money and is instead building a $300-million children’s hospital. Although such a facility is no doubt worthwhile, Lewis points out that Saskatoon already has three hospitals and that a community-based clinic would have tremendous positive effects on a troubled region that’s desperate for help. (That community health centre, called Station 20 West, is going ahead on a smaller scale, thanks to fundraising and donations.) “There’s no evidence that acutely ill children are underserved currently [in Saskatoon],” Lewis says. “We can’t significantly improve the lot of marginalized Canadians and marginalized Canadian kids if we don’t pay the tab. We’ve designed the system to fail children.”
As a result, thousands of Canadian children lack the opportunity to go on to become productive citizens, Lewis argues; every successful transition to adulthood is an enormous societal asset, while every failure is a huge and potentially lifelong liability.
Other factors come into play, including the ever-increasing cost of postsecondary education and the relatively poor wages generally paid to child-care workers. “We’re quite happy to see people who look after our cars get paid more than those who look after our kids,” Lewis says. “It really matters what the quality of daycare is.”
Lewis points to northern European countries as ones that are doing well when it comes to providing kids of all backgrounds a decent start in life. “Based on all of the indicators, those countries just do better,” he says. “Literacy rates are higher, postsecondary-education rates are higher, high-school graduation rates are higher, and crime is lower.
“If you really want to reduce the number and proportion of children who grow up in poverty and who, by the ages of five to 13, start to fall off the rails lead a life that is unlikely to be highly successful on any grounds, you really need to have a comprehensive and generous…support system that will intervene as early as possible, identify families at risk, and do whatever it takes to help kids get to school, stay in school, be fed, and get help when they’re struggling academically.
“People have a lot more sympathy spending on children than spending on families, but kids live in families,” he adds. “If that environment isn’t thriving, it doesn’t matter if you have free lunch at school or an hour tutor after school; you’ve got to help families overcome dysfunction as well.” (BC Child and Youth in Care week runs Sunday to next Saturday (May 20 to 26) to celebrate the accomplishments and resilience of kids in and from care.)
If decision makers aren’t swayed by the plea to help disadvantaged people, Lewis says, maybe they’ll be convinced that tangible change is necessary, and fast, because of the economic implications.
“In Saskatoon, we’re booming now, but we have a labour shortage,” he explains. “We have a large aboriginal population with…a low rate of high-school graduation. The future of our expanding economy lies in whether we manage to educate young aboriginal people and offer quality after-school programming.
“The older the population gets, and as baby boomers exit the work force, it could create economic problems if there aren’t qualified, healthy, well-adjusted young people to take over. The cost of failure is high.”
Steven Lewis speaks at the Morris J. Wosk Centre for Dialogue on Wednesday (May 23) from 9:30 a.m. to noon.