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OPINION | Health | Coronavirus

We’re Moving towards a Healthier,More Equitable Society. Don’t LetProgress StopCOVID-19 is a fast track to ‘health in all policies.’

Vanessa Brcic , Today | TheTyee.caVanessa Brcic is a family physician, vice-chair and cofounder of the Basics for Health Society and a research

associate at the Canadian Centre for Policy Alternatives-B.C.

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The pandemic has already highlighted the urgent need for better conditions and job protection for long-term care workers. Let’s keep themomentum going. Photo by Graham Hughes, the Canadian Press.

H eartbreaking stories have emerged from their regular invisibilityduring the pandemic — hungry children, isolated elders,violence and child abuse, often with poverty or trauma at the

root. Injustices experienced by many people in Canada predated thepandemic, and it hurts to witness it.

Meanwhile, equitable societies are better for everyone in them. InJanuary, an article in the Canadian Medical Association Journal called forimmediate action on injustices through a “health in all policies” actionplan. Suddenly, we’re seeing it unfold. We mustn’t forget this as the lure ofausterity policies and economic recovery post-COVID 19 forces theseinjustices back under a cloak of “normalcy.”

Equity is that painful lens the virus is forcing us to look through en masse,and through it we see injustice: What is making people sick? Who isfalling through the cracks and suffering health consequences as a result?Who is being marginalized by systems set up to fail them?

We have been forced to pay attention to these (same old) questions duringthe pandemic because isolation is a privilege, we are in this together, andwe have an ethical obligation not to further marginalize people throughour pandemic action plans.

A D V E R T I S E M E N T

Many of us have been fighting for recognition of inequities — and povertyas an epidemic of its own — for decades, with minimal traction. We aretold to avoid using terms like social determinants of health, because it“turns people off.” Truth is, people don’t like thinking about inequitybecause it makes people with privilege uncomfortable, and the solutionsare complex.

But discomfort is alleviated through action. Suddenly, a virus emergesthat rallies us. We now see:

• Financial aid, a small boost to inhumane welfare rates, and discussionabout universal basic income.

• Job protection for long-term care workers in B.C., and attention tohorrific conditions linked to the privatization of elder care.

• A hard look at food security and the injustice of relying on charitablefood banks.

• Help for people experiencing homelessness (In March, a team includingmyself published evidence-based guidelines on this topic; we need moremovement towards housing first.)

• Access to a safe drug supply.

• And more.

This is why we need a “health in all policies” approach. Acting upstream isbetter for everyone and saves money on health care by not trapping peoplein unhealthy conditions that we know lead to downstream disease —things like forcing families on social assistance to live below the povertyline and not giving them a (meagre) supplement for healthy food untilafter they are diagnosed with diabetes.

The landscape of people struggling during the pandemic is vast, and themental health and intergenerational impacts of stress are less visible thanthe daily COVID-19 statistics. The logistics of getting (and affording)basic needs is overwhelming for single moms, elders, people withdisabilities, mental illness, and many others. Too many workingCanadians live without a safety net, and many groups are calling forguaranteed livable incomes.

Many people on the pandemic’s frontline are undervalued: people stayinghome with insufficient support, food producers, farmers, grocery staff,couriers, janitorial staff, daycare providers, support workers. Let’s cheerfor them at 7 p.m. and fight for living wages for them, too.

Evidence of the inequitable impacts of the virus is mounting. Impacts onthose with less privilege are more visible in New York and globally whereisolation may cause more death from deprivation and preventable diseasethan COVID-19 ever would. Canada also has income inequality, childpoverty, gender inequity and Indigenous communities with limited healthcare capacity. The pandemic is exacerbating inequity here as well.

Considering the health impacts of all policies will enable us to confrontlooming questions: How will we act on the parallel epidemics of opioidaddiction, mental illness and child abuse? Are elders in long-term carefacilities suffering more from neglect and isolation than they would befrom an earlier death? What about those grieving devastating tragediesalone? These are difficult questions to answer, not excuses for inaction.

A D V E R T I S E M E N T

COVID-19 presents an opportunity for public health systems to act inways that they are good at. There is a protocol for pandemic management,so we act. The same doesn’t quite exist for inequities, but there is evidenceand momentum.

A “health in all policies” approach has begun in the pandemic and canextend beyond it. We need more critical thinking and continualimprovement through trial and error, both in social policy and in healthcare. Health care reforms must re-orient towards equity, and whereprograms are insufficient or incomplete, we can roll out better solutions.We started with urgent policy responses, and now is the time to getcollaborative by engaging the public and equity-oriented organizations.

Inaction on inequities will compound harms of the pandemic. Byprotecting the most vulnerable during the pandemic, we are on a fastertrack to a more equal society. We can’t stop. Acts of altruism andgenerosity are keeping us going. Now is our time to make that happen inall policies so that we don’t leave anyone behind, through the COVID-19era and beyond.

Read more: Health, Coronavirus

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Art Merz • 9 hours ago

and the reason why certain provinces are trying to open sooner, is they arenot interested in evoving inro a better, fairer or cleaner system. They do not

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