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Latest OECD figures confirm Canada as a public health laggard

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Raphael, Dennis
Publication Date: 
18 Jul 2011


Despite ongoing calls by the corporate sector and conservative pundits for a weakening in the size and strength of the Canadian welfare state, it is well established that having a strong welfare state is an important determinant of a society's overall health and quality of life.

For decades now, Canadian leaders have been bent on reducing our welfare state - that is, the benefits and services that Canadians get as a matter of right. Our declining rankings in a number of health and quality of life indicators compared to other nations have been the result.


Recent figures produced by the Organisation for Economic Cooperation and Development (OECD) confirm this disturbing trend. The recent release of Society at a Glance: 2011 OECD Social Indicators by the OECD provides further evidence of Canada's mediocre performance in developing public policy that supports health. Evidence is available in three key areas that tell us about our quality of life: governmental spending on economic and social support of Canadians, income inequality and poverty and health outcomes.

It is well established by the OECD and the Conference Board of Canada in its annual reports cards on Canada's performance that governments that provide greater economic and social resources to the population in the form of public services and citizen benefits and supports show evidence of better overall health and quality of life.

These include things such as child care, family benefits, health and social services and investments in employment training, education and recreation activities. Canada's poor performance is not apparent only in comparison to the social democracies of Scandinavia (ie. Finland, Norway and Sweden).

It also applies to what political scientists call the conservative nations of Continental Europe (ie. France, Germany and Holland). Economic performance among these stronger welfare-state nations is excellent, as well.

In 2007, Canada ranked 23rd of 34 OECD nations in this important indicator, allocating just 16.9 per cent of its gross domestic product to citizen support through social spending. The OECD average was 19.3 per cent. These benefits would normally be directed to families, seniors, persons with disabilities and workers losing their jobs who require support.

Not surprisingly, Canada compares poorly to other OECD nations in terms of income inequality and poverty rates as nations with stronger welfare states do better on these indicators. Canada ranked 22nd of 34 nations in income inequality and 21st of 34 nations in poverty during the late 2000s. Canada's income inequality rate increased since the 1980s, while its poverty rate showed a very slight decline. Income inequality is an important corrosive for societal cohesion and overall societal quality of life.


The evidence suggests Canada's mediocre health outcomes are a reflection of its continuing to expend rather less resources toward citizen supports than other OECD nations through social governmental expenditures. This trend can be expected to accelerate with the recent election of a majority Conservative government. Continuing evidence of a decline in relative improvement in population health as compared to other OECD nations can be expected. The benefit of the meagre reductions in taxes that the average Canadian receives from the reduction of the strength and scope of the welfare state comes at a dear cost.

Dennis Raphael, PhD, is a professor of health policy and management at York University. He is coauthor of Social Determinants of Health: The Canadian Facts.