Social change could create healthy population

In the 1970s, a flurry of discussion started over a report stating that the average 60-year-old Swede was about as healthy as the average 30-year-old Canadian. The two main culprits, according to that study, were diet and exercise.

Perhaps the study should have highlighted a third major culprit: the social and cultural factors that keep many people, especially the poor and marginalized, from living healthy lives.

I recently attended the book launch for The Social Determinants of Health (second edition), which includes chapters on topics such as food insecurity, immigrant and refugee health and the politics of disease. The readings and discussion helped to expand on and confirm the trends that I had already noticed regarding the connection between poverty, social exclusion and health.

It is easy to assume that people are poor or marginalized because of some character flaw or lack of effort, and that many of these people are unhealthy for the same reason. Either they have not tried hard enough to succeed or they have wasted their money on frivolous purchases instead of healthy food and outdoor activities.

How close to the truth is that kind of opinion? In my experience, it is far from accurate.

Healthy food too costly for some

It seems to me that the key to maintaining good health for the average, relatively disease-free person falls into two main categories: good food and exercise. Yet it sometimes appears that there is almost a deliberate campaign to ensure that marginalized people fall behind in these areas.

Yes, many people make unnecessary purchases such as alcohol or cigarettes, and both the rich and the poor often prefer to sit inside watching television rather than getting exercise, but circumstances can sometimes be against them. When fresh fruit is substantially more expensive than junk food and cities are set up to accommodate drivers rather than pedestrians, being healthy can be a challenge.

When I lived in Inuvik, N.W.T., more than a decade ago, I discovered a probable reason why some of the local people tended to give their children chocolate and candy rather than fruit and vegetables for after-school snacks. Spending $10 or more on a few apples that looked like they had been sitting in a truck for months was not something I particularly wanted to do, and many other people seemed to feel the same.

I can imagine that a family living on social assistance or on a single salary in Inuvik would find it even more difficult than I did to eat healthy food. Without government or business intervention to keep eating affordable, staying healthy is a difficult task in many remote communities. 

Even in Winnipeg, the rising cost of food makes it difficult to afford a balanced and varied diet, leaving many people reliant on food banks. According to Winnipeg Harvest, Manitoba consistently has the highest proportion of food bank users in Canada, and 45 per cent of them are children.

Fitness proves challenging in car culture

After leaving Inuvik, I went to live in Grande Prairie, Alta., where food was still expensive but much more affordable than in the town that I had left. However, I soon discovered that the dominance of the truck and car culture made the other major element of good health very difficult.

In Grande Prairie, roads were fairly well-kept, but sidewalks were badly cleared in winter and even entirely nonexistent in some parts of the city. Riding a bicycle was an option for determined cyclists, although it was not for the faint of heart, considering all of the pickup trucks and other large vehicles on the roads.

Solving deeply entrenched social problems like these can be difficult, but sometimes even the simplest ideas can make a huge difference. For example, violent crime in the city of Bogota, Colombia, dropped significantly after a visionary mayor invested in green spaces and public areas, among other measures, allowing people to interact peacefully rather than kill each other.

Surely Canadians can find simple answers to some of the problems that this country faces. We'll all be better for it.

Susan Huebert is a Winnipeg writer and editor.