In General, PEGASIS

New research shows that the health of Canadians can be improved by funding community supports. Tim Henderson comments on how this concept is integral to the work of the Pan-Edmonton Group Addressing Social Isolation of Seniors.

Commentary on Effect of provincial spending on social services and health care on health outcomes in Canada: an observational longitudinal study published in CMAJ (Canadian Medical Association Journal) January 22, 2018.

Researchers at the University of Calgary have concluded that “Population-level health outcomes could benefit from a reallocation of government dollars from health to social spending, even if total government spending were left unchanged”. The team from the School of Public Policy at the University of Calgary conducted an analysis of government spending by nine provinces between 1981 and 2011 and aggregated measures of health outcomes over the same time frame. They concluded that “the results of our study suggest that spending on social services can improve health. Social policy changes at the margins, where it is possible to affect population health outcomes by reallocating spending in a way that has no effect on the overall government budget.”

Interestingly, they found that the consequence of reallocating one cent of every dollar spent on health care to social programs will have a far greater impact than increasing health spending. The example they used in their paper showed that a one cent increase in social spending for every dollar of health spending in 2011 by the Province of Ontario would be an additional $350 million, or a 2.6% increase, for social programs. A $350 million decrease in health care funding would be only 0.8% of the 2011 level of health spending in Ontario. They predicted that such a reallocation would produce better health outcomes than a 1% increase in health spending.

This is an interesting examination of spending priorities, but we need to keep a couple of things in mind: with an aging population, we are not going to see any significant decline in the demands for health care services, and increasing social spending is a preventative public policy that will have positive benefits over time. What this research seems to suggest is that by allocating greater spending for social programs, we can reduce the need for some types of health spending and improve health outcomes over time. If we couple these results with some observations made by Dr. Richard Lewanczuk from the University of Alberta, we may be able to reduce some of the demands for high cost emergency room and acute care services for seniors by providing better funding for social supports for people, particularly seniors, that contribute to better health and better non-emergency support for seniors experiencing the inevitable deterioration of health due to aging.

What does this mean for us here in Edmonton? We have a broad array of services and community supports for youth, families, immigrants, and seniors, but funding is fragmented, and we all work independently of one another. A commitment from the provincial government to fund community supports would likely have significant benefits in the way of better support for families and caregivers of seniors, better health outcomes and improved resilience of individuals as they age, and resulting reductions in the demand for high-cost emergency room and acute care services and facilities.

We will always need doctors and emergency rooms, but we may be able to reduce the rate at which health care spending is increasing, make better use of our existing facilities, programs, and services, and help to support and improve the quality of life of an aging population. The goal is to create a stronger community by providing the services that support individual and collective health and well-being. Health care and social supports should be complementary, not in competition with one another, and not operating independently of each other.

Other good articles on this topic:

Canada must rethink health spending strategy
Andre Picard
Globe and Mail

Canada should spend less on health care, more on social services: study
CTV News

Want a healthier population? Spend more on social services, less on health care: study
Torstar News Service/Metro Edmonton

by Tim Henderson, Project Manager, Pan-Edmonton Group Addressing Social Isolation of Seniors

Effect of provincial spending on social services and health care on health outcomes in Canada: an observational longitudinal study
Daniel J. Dutton PhD, Pierre-Gerlier Forest PhD, Ronald D. Kneebone PhD, Jennifer D. Zwicker PhD
CMAJ 2018 January 22;190:E66-71. doi: 10.1503/cmaj.170132