Dr. Gary Bloch's Presentation to University of Toronto Masters in Family Medicine

2. Bringing Health to Poverty: A Call to Action for Health Providers Gary Bloch MD CCFP St. Michael’s Hospital, Seaton House Shelter Health Providers Against Poverty ( Masters Candidate, M.H.Sc.) April 25, 2007

7. Figure 3.2: Percentage of Canadians Living in Poverty, 2004 Source: Statistics Canada (2006). Persons in Low Income Before Tax, 2004, CANSIM Tables. Courtesy of: Dennis Raphael

8. Figure 3.7: Percentage of Canadians, Children, and Individuals in Female Lone-Parent Families Living in Poverty by Province, 2004 Source: Statistics Canada (2006). Persons in Low Income Before Tax, CANSIM Tables. Courtesy of: Dennis Raphael

12. Population Level Indicators

14. Adler, N. (2001). A Consideration of Multiple Pathways from Socioeconomic Status to Health. In J. Auerbach and B. Krimgold (eds.). Income, Socioeconomic Status, and Health. Washington DC: National Policy Association, Data from NCHS, 1998. Courtesy of Dennis Raphael

17. Odd of Reporting Fair or Poor Self-Rated Health: Ontario, 1996 Source: Xi et al. (2005). “Income inequality and health in Ontario”, CJPH, 96, 206-211 Adapted from: Dennis Raphael

19. Chronic Disease

20. [i] Adapted from Wilkins, et. al., 2002, 14-15. 47% Females 56% Males Diabetes 30% Both sexes Mental Disorders 241% Both sexes Infectious Diseases 56% Males Lung Cancer 50% Females Uterine Cancer -5% Females 150% Males Cirrhosis 25% Females 31% Males Ischemic Heart Disease 32% Both sexes All causes Increase in Mortality in lowest vs. highest income quintile neighbourhoods Cause of Death

21. Adler, N. (2001). A Consideration of Multiple Pathways from Socioeconomic Status to Health. In J. Auerbach and B. Krimgold (eds.). Income, Socioeconomic Status, and Health. Washington DC: National Policy Association, Data from NCHS, 1998. Courtesy of Dennis Raphael

25. Courtesy of Dennis Raphael

27. Children’s Health

28. Annual Family Income and Percentage of Children with “Lower Functional Health” Functional Health includes testing for vision, hearing, speech, mobility, dexterity, cognition, emotion, pain and discomfort Prepared by the Canadian Council on Social Development using the National Longitudinal Survey of Children and Youth, 1994-1995 Adapted from Dennis Raphael

29. Income and Children’s Problems Source: National Longitudinal Survey of Children and Youth Courtesy of Dennis Raphael

34. Courtesy of Dennis Raphael

35. Source: OECD (2004). Social Expenditure Database www.oecd.org/els/social/expenditure Courtesy of Dennis Raphael

36. Courtesy of Dennis Raphael

37. Source: Organization for Economic Cooperation and Development. (2005). Society at a Glance: OECD Social Indicators 2005 Edition. Paris, France. Figure SS6.1, p.45. Courtesy of Dennis Raphael

38. Source: Daily Bread Food Bank (2006). 2005 profile of hunger in the GTA. Toronto: DBFB.

48. Changes to Initial Assessments What is the highest level of education you have achieved? If you are from another country, is your education recognized here? Education What supports do you currently have, from family, friends, or your community, in this city and elsewhere? Social Supports What is your current living situation? Have you ever been homeless? Do you feel your housing is stable and permanent? Housing If you are on social assistance, have you applied for additional income through supplemental allowances or disability support programs? Social Assistance What is your current income level? What are your current sources of income? Who does this income support? If you are working, do you feel your job is secure and do you have room for advancement? Income Intake Questions Social Determinant of Health

49. Additional Interventions for Periodic Health Exam Consider poverty a risk factor for chronic and acute disease, and assess consider earlier screening for high prevalence conditions: e.g. cardiovascular, respiratory, liver disease; cancer; mental illness; addictions; ( etc. ) Referral to social worker, employment counselor, antipoverty advocates Support of application for disability supports Assessment of eligibility for social assistance supplements