Via The Globe and Mail, a great op-ed piece by economist Jim Standford: To manage health costs, invest in social well-being. Excerpt:
There is now hard medical evidence that a person’s economic status and social participation directly affects their physical health. And that, in turn, affects the cost of health care.
This is not vague, bleeding-heart sentimentalism; it is hard scientific proof. For concrete physiological reasons, human health suffers when people are subjected to prolonged hardship, stress and disparity. The physiology of this connection involves many body systems, including the impact of stress and unhappiness on metabolism, hormone production, circulatory function and other systems.
This research is well-established in medical journals, was popularized by British epidemiologist Richard Wilkinson in his best-seller The Spirit Level, and was further affirmed by the World Health Organization in a recent expert commission.
What does all this mean for health-care finance? It means that addressing the underlying social problems that scientists now know cause so much ill health, can help to rein in health costs.
Governments must therefore be holistic in their programming and budgeting, instead of obsessing on reducing one budget line without regard to how that may affect other expenses.
Diabetes, for example, is an illness with especially strong links to poverty and inequality. Incredibly, poverty is a greater risk factor in diabetes than diet or exercise. Canadians with annual incomes under $30,000 are at least twice as likely to contract diabetes as those with incomes over $80,000.
Poverty thus drives up the overall incidence of diabetes – and public-health costs in the process. Researchers estimate that one in 10 hospital admissions in Canada are due to diabetes and its complications; the Canadian Diabetes Association tallies total direct health costs at over $13-billion per year.
Ironically, however, while medicare shells out billions to treat diabetes, we penny-pinch when it comes to supporting poor people so they don’t get it in the first place.
Comments