Transcript Women`s Health in Atlantic Canada 2003 Update Prince

Genuine Progress Index for Atlantic Canada
Indice de progrès véritable - Atlantique
Social and Economic DevelopmentAre They Compatible?
Ronald Colman Ph.D,
FEDC-DM, Halifax, 19 March, 2003
The Convergence of
Economic and Social
Development
New economy brings
• New social faultlines, and
• New opportunities in
society.
New Economy….New Faultlines
• Knowledge economy may exacerbate education and
health disparities
• Dismantled trade barriers have major impact on
domestic firm structure, work hours, work security
• Women doubled employment rate affecting gender
roles, children, family structure, time stress
• Era of fiscal restraint shrinks health and social
supports, social capital is stressed.
• Natural resource consumption has deeply altered
fishing, forestry, farming, water resources.
More consumption of
goods…. But natural world
is poorer
Result: Economic Developers
Face New Paradigm
• Economic and social development inseparable.
• Global evidence: greater income equality is
related to economic success and higher
productivity.(Savoie, Osberg, Sharpe, et al)
• Realistic view of “capital” includes human,
natural, and social capital…. and their depletion.
• Costs of ill health, illiteracy, crime --crowd out
investment in productive infrastructure.
Full cost accounting
shows:
Unemployment, poverty, inequality, poor
education bring…
• higher costs of health care, crime;
defensive expenditures
• loss of innovation potential….by waste of
precious human assets (C. Leadbetter, et al;
Livingstone, 1998)
Full-cost accounting improves market
efficiency, (eg energy conservation); AND
obviates need for heavy-handed
government regulation
E.g. Health costs of
inequality ….
• Low income women 15-39 = 62% more
likely to be hospitalized than high income
women; 40+ = 92%. Men < 40 = 46%; 40+
= 57%
• No high school = use doctors 49% more cf
BA; Low income = 43% more than higher
income. $70 mill/yr = excess use due to
inequality
• If all Nova Scotians were as heart healthy
as higher income NS = save 200 lives,
$124m /yr
….delayed development
in children
• 31 indicators - as family income falls,
children have more health problems,
(NLSCY, NPHS, Statistics Canada)
• Child poverty -> higher rates
respiratory illness, obesity, high
blood lead, iron deficiency, FAS,
LBW, injury, delayed development,
poor job prospects….+….
….Poverty is costly!
The high costs of poor
education and
unemployment
• 42% NS prison inmates have less than
Grade 10 education (cf 19% population)
• Aboriginals jailed at 4 times pop. Rate
• 67% unemployed at time of admission
(=5x population rate)
= Costly:
• $44,165 inmate/year; cf 3-year SMU tuition, room, board = $33,200
Economic developers
…new paradigm
• Quality of life influences location decisions especially for knowledge economy sectors
• Efficiency and equity no longer a tradeoff…. new
notions of competitiveness
• Longer- term innovation capacity more important
for sustainable development than short-term
productivity gains
Economic developers …
Area Development magazine- corporate
surveys say knowledge-based sectors watch
quality of life indicators…
• crime rates
• recreation,
• environment (air quality influences CEO location)
• education, health care
Quality of Life a Proven
Economic Development Issue
• US cities which invested in quality of
life and social infrastructure retained
best and brightest. (Richard Florida, 2002)
• Montreal resurgence explained by
economic and social attractions - I.e.
environment, arts, festivals, recreation,
diversity.
More awareness of Econ-Social
links, awareness of indicators
Quebec election, social issues are in the
forefront:
“We have one of the world’s highest suicide
rates among young people, one of the highest
divorce rates, one of the highest rates of
single-parent families, not to mention North
America’s highest abortion rate and lowest
birthrate. What are the people we elect to
govern us doing to solve these problems?”
Henri Comte, president, Medianor, Globe & Mail (Mar 15)
Challenges in advancing new
paradigm are major
• Current indicators equating GDP
growth with wellbeing are misleading for policy makers and public alike. E.g. Higher
fuel consumption and crime rates make
economy grow
• Data availability limited by current view
• Silo nature of government
• Requires long-term vs short-term (4-5 yr)
thinking (investment orientation)
Government Silos…. costly
examples
• Tobacco control: need ministries of Health,
Education, Finance, Tourism at table
• Employment: Government and unions failed
to cooperate on voluntary work time reduction
to avoid layoffs (Albany NY model)
• Equity and social inclusion-no ministerial
portfolio (UK now has one)
Human, social, natural
capital depreciate invisibly
if not counted
1) Health as human capital investment
• NS workers lose more work days due to illness and
disability (8.3/yr) compared to Canada (7), Ontario (6)
• If NS workers were as healthy as Canadian workers,
economic savings would be $63 m. /year. If NS
workers matched Ontario = savings would be $97 m.
• Health promotion pays = In NS healthier workers can
save economy almost $100 million per year
Current indicators send
misleading messages
 Canadians spend $10 billion buying 40 billion
cigarettes – counts as economic growth
 Canadians will spend $12 billion on fast food.
Tim Horton’s will open 170 new stores
 Taxpayers will spend $6 billion treating
smoking and obesity-related illnesses
 We spend $103 billion treating sickness, up by
6.5 per cent a year since 1998, and double the
spending in 1980 – “growth industry”
Measuring wellbeing more
accurately
 ask what is growing, not just how much is growing;
 distinguish assets (eg health, security) from liabilities (eg
sickness, poverty); count sickness as cost, not gain to
economy; value health as human capital subject to
depreciation
 value health and its key determinants (e.g. equity,
education, livelihood security, environmental quality) as core
measures of wellbeing;
 Policy implication = shift focus of action from an almost
exclusive preoccupation with treating illness to a greater
emphasis on improving health and preventing disease.
2) Social capital Volunteerism
But fewer
volunteers/longer hrs. =
depreciation of social
capital
1997
Canada
7,472
2000
%
change
6,513 -12.3%
Nfld
150
138
-8.0%
PEI
38
40
+5.2%
N.S.
283
253
-10.7%
N.B.
208
174
-16.3%
3) Natural capital
depreciation
Incentives to move ahead
– NS as Nth American
leader
• Control health costs through health promotion
• Outstanding models: Holland (work), Denmark
(wind), UK (health), NS (waste)
• Explosion in markets for clean technology,
organic agriculture, sustainably harvested wood
• Good news stories - new indicators would
recognize and count assets of Atlantic Canada
“Smart Growth” Movement
• Conference- Vancouver, March, 2003
• Austin, Texas - development projects must
pass 13 sustainability criteria
• Melbourne - “triple bottom line”:
economic, social and environmental
criteria for development
• “Slow Cities” movement - Italy, Europe.
Fed-provincial policy shift
occurring
• Inter-jurisdictional: federal-provincial
initiatives like BBI, CEED, skills-building,
innovation, sustainable communities
• ACOA – CED, inclusive entrepreneurship &
loan provision, e.g. FRAM, ABSN
• Inter-sectoral initiatives; Fed. Cabinet social
and economic committee rotating chairs;
Commissioner of Sustainable Development
• Social determinants of health recognized
Provincial initiatives e.g.:
• Newfoundland Strategic Social Plan;
Social Audit; Community Accounts
• Manitoba legislated sustainability
indicator reporting
• Quebec – Anti-poverty law; four-day
work week proposal
• AACC – organic agriculture initiative
• NS – Office of Health Promotion
Innovative policy e.g:
Adjusting to new
employment realities
Statistics Canada, General Social Surveys, Households’ Unpaid Work, Labour Force Surveys, Women in
Canada, Women in the Workplace, CANSIM
Dual Earner Families as
Percent of All Families in
Canada
Statistics Canada, Characteristics of Dual-Earner Families, Charting Canadian Incomes 1951-1981,
Women in Canada
Labour Force Participation
Rate, Mothers with Infants, 02, Canada,
Statistics Canada, Canadian National Child-Care Study, Labour Force Annual Averages, Charting
Canadian Incomes 1951-1981, Caring Communities
Working Mothers = 75 hours /
week 38% highly time
stressed
Domest ic
Work 2hrs
24mins
Primary Child
Care 36mins
Paid Work
7 hrs, 12mins
Shopping
54mins
Education
12mins
Statistics Canada, General Social Survey; Andrew Harvey et. al., Where Does Time Go?, Statistics
Canada GSS Analysis Series
Long Work Hours and
Health
• Women moving to longer work hours:
– 4+ times more likely to smoke
– Twice as likely to increase alcohol
consumption
– 40% more likely decrease physical
activity and gain weight
– 2x likely experience major depression
• Links to anxiety, strain, irritability, fatigue,
sleeplessness, poor eating habits
Long Work Hours and
Health
• Less parental time with children may affect
mental wellbeing of youth
• May hasten family breakdown
• Long-term subtle health consequences:
Nova Scotians spend 30% less time in
kitchens than 1992, eat more fast food -impacts obesity, health of children
(Harvard study)
IN SUM – economic, social realities
inseparable and must be approached as
one
Hours per week spent Cooking and Washing Dishes,
Nova Scotia 1961-1998
9
8
7
6
5
4
3
2
1
0
8
7.7
6.7
8.4
6.7
4.7
1961
1971
1981
1986
1992
1998
Statistics Canada, General Social Survey, Households’ Unpaid Work, Harvey et. al, Where Does Time
Go?, Chris Jackson, The Value of Household Work in Canada.
NS can be 1st in Canada to
implement leading-edge
employment practices
• Voluntary work-time reduction can
increase employment, productivity
• Improve balance: work, family, free
time
• Dutch part-timers get equal hourly
pay, pro-rated benefits, equal
opportunity career advancement.
Dutch put in 1,370 hrs/yr compared
to 1,732 (Canada)
Nova Scotia can be
environmental leader
• Solid waste management- recycling• Smoke-free public places,
• HRM first to ban lawn pesticides
• Halifax Harbour, Sydney Tar Ponds
• Kyoto as economic opportunity….
Can we do it?
% Waste Diversion in Nova
Scotia
First Steps Forward
1) Full-cost accounting, reporting of where we are with
current data. Public costs, savings estimated = WHAT
2) Understanding, analysis of key linkages between
social, economic, environmental outcomes = WHY
3) Identify targets and objectives = WHERE TO.
4) New indicators are identified publicly and adopted.
Independent verification by statistics agencies, others.
5)A cross-sectoral strategy and champions to promote
objectives, monitor progress, get started = HOW
The challenge now - to
integrate social and
economic development
Will we play hesitation…... or
leapfrog?
The Challenge and Opportunity
for Economic Developers: Step
One...
• Inaugurate full-cost economic reporting to include
human, social, and natural capital along with the
manufactured and financial capital already counted.
• Statistics Canada has endorsed this approach, and
created a framework. Methods, data available.
• Provides a bold, accountable basis for policy
initiatives that join social, economic development
• Nova Scotia could become first province to
implement it, serving as pilot and model for Canada
What kind of world are we
leaving our children? – It’s
up to us….