First they came for the whales

First they came for the whales

Dr. Trevor Hancock

2 December 2019

701 words

While there has been an increasing public focus on climate change in the last few years, and a slow awakening to the threat it poses, we have yet to wake up fully to an even bigger problem. I noted in a September 2019 column that we face not only a climate emergency but an extinction emergency.

A 2018 article in the Proceedings of the National Academy of Sciences sheds light on this. It reported on a census of the biomass of the Earth – the weight (measured as carbon) of all living things. Just over 80 percent is plants, while another 12 percent or so is bacteria; fungi make up about 2 percent and the entire animal kingdom makes up less than 0.4 percent of the Earth’s biomass.

Within the miniscule fraction that is the animal kingdom, about half the biomass is marine arthropods, with most of that being crustacea (e.g. crabs, shrimps, lobsters and Antarctic krill) and another 35 percent is fish. Land vertebrates are only about 0.03 percent (three ten-thousandths) of the weight of all living things, with humans making up about one third of that (0.01 percent). We are outweighed by our livestock, and roughly matched by both Antarctic krill and termites. That should make us feel small and humble!

But while small, we are also mighty. The article notes it has been estimated that “the present-day biomass of wild land mammals is approximately sevenfold lower” than it was 50,000 years ago, before we started wiping out the large land mammals. As a result we now outweigh wild animals ten-fold. They also report that our hunting of whales and other marine mammals has led to a roughly five-fold decrease in their biomass, while we have roughly halved total fish biomass.

It’s not just animals that we have harmed; the authors point to evidence suggesting “the total plant biomass (and, by proxy, the total biomass on Earth) has declined approximately two-fold relative to its value before the start of human civilization”. Given that plants make up roughly 80 percent of the total biomass, that is an astonishing level of impact, one that is not compensated for by our crops, which, they report, account for only about 2 percent of total plant biomass.

Small wonder, then, that the International Union for the Conservation of Nature reports there are more than 28,000 species threatened with extinction, which is 27 percent of all the species they have assessed. This includes four in ten assessed amphibian species, one quarter of all mammals, almost a third of the sharks and rays and in the plant kingdom, a third of conifers and more than half Europe’s endemic trees.

Contemplating what amounts to a holocaust in the animal and plant kingdoms, the famous 1946 confession of the German Lutheran pastor Martin Niemöller came to mind: “First they came for the socialists, and I did not speak out – because I was not a socialist. Then they came for the trade unionists, and I did not speak out – because I was not a trade unionist. Then they came for the Jews, and I did not speak out – because I was not a Jew. Then they came for me – and there was no one left to speak for me.”

In the face of this sixth Great Extinction of life that humanity has initiated, I think we need an updated version, a lament for the web of life:

“First they came for the whales and the sharks, the salmon and the cod and I did not speak out – because they were but sea creatures. Then they came for the elephants and the tigers, the rhinos and the bears, and I did not speak out – because they were only animals. Then they came for the birds and the insects, the reptiles and the frogs, and I did not speak out – because they were small and unimportant. Then they came for the trees and the grasslands, the ferns and mosses, and I did not speak out – because they are just plants. Then they came for me – because we had so damaged the great web of life that everything I depended upon for life was gone.”

© Trevor Hancock, 2019



Poverty and the Olympian fallacy

Poverty and the Olympian fallacy

Dr. Trevor Hancock

26 November 2019

699 words

I was not surprised to receive feedback from a couple of readers objecting to the conclusion of my column last week. In it I explained that economic growth was not the solution for poverty, partly because it does not work very well and partly because further growth of our existing economy is not possible in a finite world where ecosystems are already becoming overwhelmed. Instead, I wrote, we need redistribution of income – and, I should have added, power and resources – from rich countries to poor countries and within countries, from rich people to poor people.

Both readers wrote that they had worked hard and got a university education. One noted “People have to have the desire, focus, and strength to change. Changing social standing, from my experience, is a personal choice”, while the other wrote “I remember well talking to my parents when I was a kid growing up, it was made clear to me that if any wealth was going to be distributed it should be up to the individual, certainly not the state”.

Both of these responses have aspects of what I call the Olympian fallacy, something we sometimes hear from Olympic athletes and other high achievers: I worked hard and was very successful, so you can do the same. The implication, of course, is that we all have an equal chance and if you don’t succeed it’s your own fault.

But the argument is fallacious for two major reasons. First, we are not born equal because we differ genetically. Some people are bigger, faster or stronger than others because they got the right genes. Of course training helps, as does dedication to that training, but having the right genes also helps. And its not just genes for physical attributes but also for psychological traits, which are defined in the American Psychological Association’s dictionary as “an enduring personality characteristic that describes or determines an individual’s behavior across a range of situations”.

Thomas Bouchard, a psychologist, geneticist and professor emeritus of psychology at the University of Minnesota, is known for his studies of twins who are separated and grow up in different environments, but with essentially the same genetic makeup. In a 2008 book chapter he noted that “genetic variation is an important feature of virtually every human psychological trait and must be taken into account in any comprehensive explanation (theory) of human behaviour”.

In a 2004 article he reported the genetic influence on personality – including such traits as extraversion, agreeableness or aggression, conscientiousness, neuroticism, openness, positive or negative emotionality and constraint – is about 40 to 50 percent, while it is about 36 percent for vocational or occupational interest. Genetic factors also play a significant role in mental ability and social attitudes. You can see how this might affect your ability to succeed.

Interestingly, he reports that the genetic influence on some traits vary with age, with genetic influences on mental ability and social attitudes such as conservatism and religiousness being low in young people, but increasing with age – meaning that socio-environmental influences on young people can counteract a genetic predisposition.

This points to a second major problem with the Olympian fallacy; it’s not just nature, it’s also nurture – our environment matters. We all experience different cultural, socio-economic and physical environments growing up, and these conditions influence the choices available to us.

Add to that mix factors such as colonisation, dispossession and racism, or on the other hand inherited wealth, and the scales are tipped further, one way or the other. Then add in slum housing, oppressive governments or employers, resource depletion and an economic system that, left to its own devices, leads to wealth moving up, and you can see why we don’t all have an equal chance.

This is not to deny the role of the individual who is determined and works hard – although remembering that there is a significant genetic influence on personality at work. But it depends also on where you start from and the opportunities you have, it’s not all down to the individual.

Which is why a fair, just and compassionate society will try to level the playing field by redistributing wealth, power and resources to those most in need.

© Trevor Hancock, 2019



Economic growth won’t fix poverty

Economic growth won’t fix poverty

Dr. Trevor Hancock

18 November 2019

702 words

In 2004 Roy Romanow, former Saskatchewan Premier and Chair of a Federal Commission on the Future of Health Care, gave his keynote address to the inaugural meeting of the Health Council of Canada, which was set up as a result of his report. He suggested seven things we could do to stay healthy: Number one was “Don’t be poor”.

At the global level the poverty line, set by the World Bank in 2015 at $1.90 per day, measures extreme poverty. This is the amount needed for basic shelter, food and clothing, but does not include clean water, sanitation, electricity, education or health care. In other words, the global poverty line represents mere survival, hardly even a bare existence. A more realistic poverty line, suggests David Woodward in the World Economic Review in 2015, would be $5 per day, “the income at which basic needs may be met, and social and economic rights minimally fulfilled.”

For decades the economic establishment has argued that we need economic growth to remove the scourge of poverty: A rising tide, they say, will float all boats. But there are flaws in that analogy. First, it may raise all boats, but if you are in a dugout canoe rather than a luxury yacht, you will still be in a dugout canoe. Second, if your boat has a leak, the rising tide will swamp and sink it – and a lot of people are in leaky boats.

Moreover, Woodward argues, if the pattern of economic growth and distribution we experienced from 1993 – 2008 continued indefinitely, it would take 100 years to lift everyone above the $1.25 level and 200 years to get them above $5 per day. And, he adds, to do so “global GDP would need to increase “to nearly 15 times its 2010 level by the time $1.25-a-day poverty is eradicated in 2115, and 173 times its 2010 level by the time of $5-a-day poverty eradication in 2222”. But the Earth cannot even support today’s economy, as we are seeing, never mind an economy at that scale.

In rich countries too, economic growth is not the answer. Sir Angus Deaton, a Nobel Prize-winning economist, pointed out in a July 2019 article that in America “real wages for men without a four-year college degree have fallen for half a century, even at a time when per capita GDP has robustly risen” and that “median real wages in Britain have not risen for more than a decade”. Moreover, he adds, in America “inequality has risen not only due to wealth generation from innovation or creation, but also through upward transfers from workers”. In other words, we are robbing the poor to enrich the wealthy.

So while there may have been a tiny amount trickling down to the world’s poorest – crumbs falling from the overloaded tables of the wealthy – that is vastly outweighed by the flooding up of wealth to the already wealthy. In a paper this month in Scientific American, Bruce Boghosian, a professor of mathematics at Tufts University, shows that this result is inevitable in a free market, unless there is significant government intervention.

He and his colleagues created a mathematical model of the economy which is highly accurate, matching the distribution of wealth in the US “to less than a sixth of a percent over a span of three decades” and European wealth distribution in 2010 to within half a percent.

Their key finding is that “far from wealth trickling down to the poor, the natural inclination of wealth is to flow upward, so that the ‘natural’ wealth distribution in a free-market economy is one of complete oligarchy” – a situation in which one person owns everything. Importantly, he adds, “it is only redistribution that sets limits on inequality.”

The answer to the problem of poverty, then, is not more growth – not only because the pie has to stop growing, but because growth does not fix poverty. In their book about a steady state economy, “Enough is Enough”, Rob Dietz and Dan O’Neill note “reducing poverty without global growth would require the redistribution of income from rich countries to poor countries” – and, we might add, the same applies within countries, from rich people to poor people.

© Trevor Hancock, 2019

Economic growth isn’t necessary for good health

Economic growth isn’t necessary for good health

Dr. Trevor Hancock

12 November 2019

700 words

Last week, I noted that economic growth, as presently understood and practised, is harmful, indeed malignant. This is not to say that some places don’t need economic development, and indeed economic growth. Low-income countries need a sufficiently large economy that they can afford to meet basic human needs for all. Those needs include clean water, sanitation, education, adequate supplies of nutritious foods, adequate housing and good public health and primary medical care.

But it is hard to see how accumulation of more wealth by Canadians is going to help them; we already have too much. In fact our profligate use of fossil fuels and other resources – both our own and their’s – and the concomitant production of waste and pollution, actually presents a danger to them. It is primarily low-income populations in low-income countries that will suffer most from climate change, resource depletion, pollution and loss of species.

In a finite world already showing signs of ecosystem decline the pie cannot keep growing, so it has to be distributed more fairly. If low-income countries need more of the Earth’s resources for their own development, then this can only happen if we use less. So what are we to do?

A good place to start would be to get rid of ‘bad’ economic growth – all forms of economic activity that actually make things worse by harming health, social wellbeing and the natural systems that are our ultimate source of health. This would include all forms of pollution, including air pollutants and greenhouse gases associated with fossil fuel use; tobacco and other products that harm health and further production of more ‘stuff’ that we don’t need.

This calls for a very different system of economics. Ecological economists have been critiquing the ‘standard model’ of the economy for decades. Chief among them here in Canada is Peter Victor, former dean of the Faculty of Environmental Studies at York University. His 2008 book Managing Without Growth, explored both a ‘business as usual’ (continuing growth) economy and a variety of alternative low and no growth scenarios for the period between 2005 and 2035.

He found that while a ‘no growth’ scenario could be disastrous, the right combination of low then no growth by 2035, with high government investment in poverty reduction, literacy and health care and a revenue-neutral carbon tax (at about $200 per ton, with other taxes reduced) could lead to “attractive economic, social and environmental outcomes: full employment, virtual elimination of poverty, more leisure, considerable reductions in GHG emissions and fiscal balance”, as well as wide adoption of renewable energy and energy-efficient technology and other benefits, including increased GDP per capita, if achieved without increased energy and resource use.

Similarly Dan O’Neill, another Canadian, now teaching ecological economics at the University of Leeds in the UK, has championed the ‘steady state’ economy proposed in the 1970s by Herman Daly. Recently, in his foreword to the book ‘Enough is Enough’ that O’Neill co-authored with Rob Dietz, Daly states, simply: “Enough should be the central concept in economics”, where enough means “sufficient for a good life”.

In their book, Dietz and O’Neill contrast an economy of enough with the present economy of more, summarising the latter as destined to fail “environmentally as it exhausts natural resources and exceeds ecological limits” and socially, as “diminishing returns to growth [mean that] after a point, more fails to improve people’s lives”.

A compelling case for an economy that is fit for purpose in the 21st century has been put forward by Kate Raworth in her book ‘Doughnut Economics’. The essence of such an economy is that it be large enough and distributed fairly enough that we can meet the needs of everyone on Earth for good health and a good quality of life. But at the same time, the economy cannot be so large that it undermines the ecological systems that ultimately determine our wellbeing.

For rich countries in particular, Raworth notes, this will require them to “overcome their dependency on GDP growth and develop economies that are regenerative and distributive by design”. Creating an economy that regenerates damaged natural ecosystems and distributes benefits more fairly is perhaps the greatest challenge we face in the 21st century.

© Trevor Hancock, 2019

Economic growth is malignant

Economic growth is malignant

Dr. Trevor Hancock

5 November 2019

700 words

While the exchange between my fellow columnist, Lawrie McFarlane, and myself on the issue of economic growth may seem esoteric, it is fundamental to the future wellbeing of our civilization and many forms of life on our planet, including humans. In his column last week, Lawrie took issue with my view – responding to his column about the policies of the Greens and the NDP – that continuing to pursue economic growth is mad if it meant “further harm to the Earth’s natural systems, further depletion of vital natural resources and further extinction of the species that make up the web of life – as it does in the current mainstream model of development”.

He argues that economic growth has lifted many out of poverty and brought us improved health and an improved quality of life, and that with many still living in poverty and a growing population, “we’re going to need a lot more of it, not less”. To some extent he is correct, but only if we qualify what sort of economic growth we are talking about (not all growth is good), where it is needed and by whom, and how its benefits are distributed.

First, the health benefits of economic growth are not linear. If we look at the relationship between GDP per person (GDPpp) and life expectancy for the world’s nations, we find that as GDPpp goes up, so does life expectancy, and quite dramatically – to a point. That point is about $20,000 US per person, according to a 2014 report from Euromonitor International, with life expectancy increasing more than 20 years from the lowest levels of GDPpp to the $20,000 level.

But beyond that point, further increases in GDPpp have little or no relationship to life expectancy, with a mere 2 years increase in life expectancy in developed countries between $20,000 and $60,000 GDPpp. Indeed, the Euromonitor International report showed that for the wealthiest countries “where income exceeds US$40,000, the relationship becomes inverse”. So high levels of GDP may actually be harmful.

Moreover, the most common measure of a country’s economy, its GDP, is a grossly misleading indicator, because it fails to distinguish between good and bad economic activity. For example, GDP grows if we sell more tobacco and treat more tobacco-caused disease, if we spend a lot of money clearing up oil spills, or if we produce and sell more fossil fuels and worsen climate change. Is that the economic growth we want?

In fact, the Genuine Progress Indicator (GPI) and the Canadian Index of Wellbeing (CIW) – both of which are more sophisticated indicators of social progress – show that while the economy has grown a lot, human and social wellbeing has not. An estimate of global GPI per capita published in 2013 found that it had decreased since 1978, when it peaked, that “Life Satisfaction in almost all countries has also not improved significantly since 1975” and that beyond about $7000/ GDPpp the GPI does not increase.

Similarly, for the 20 years from 1994 to 2014 Canada’s GDP grew 38 percent while the CIW increased only 9.9 percent. In other words, while the economy, as measured by GDP, may be doing better, Canadians are not feeling all that much better for it. Peter Victor, a leading Canadian ecological economist, wrote with respect to the USA that “Americans have been more successful decoupling GDP from happiness than in decoupling it from material and energy”. In other words, GDP growth is related to growth in use of materials and energy – with their attendant environmental impacts – but not with growth in the social benefits of improved happiness and wellbeing.

This is because we have lost track of a very simple concept, well described in a statement from the WWF’s 2014 Living Planet Report: “Ecosystems sustain societies that create economies. It does not work any other way round”. So growing the economy in ways that harm the ecosystems that sustain, especially when there is little or no social benefit or even harm, is a ridiculous proposition. As a physician, when I find something that grows exponentially and does harm I recognize it as cancer. Our current economic system does exactly that, and is thus malignant.

More on this next week.

© Trevor Hancock, 2019


It’s time to be responsible ancestors

It’s time to be responsible ancestors

Dr. Trevor Hancock

29 October 2019

700 words

As I listen to the increasingly shrill and heated rhetoric of Jason Kenney, and others of his ilk as they try to defend and promote the fossil fuel industry, it brings to mind a phrase from a 2015 report from The Lancet. This leading medical journal has sponsored several Commissions, often in partnership with international organisations, on the health effects of global ecological change. There have been two on climate change and one each on pollution, healthy diets from sustainable food systems, and planetary health.

The Commission on Planetary Health, funded by the Rockefeller Foundation, examined the “health of human civilisation and the state of the natural systems on which it depends”. In their report, the Commission noted “we have been mortgaging the health of future generations to realise economic and development gains in the present. By unsustainably exploiting nature’s resources, human civilisation has flourished but now risks substantial health effects from the degradation of nature’s life support systems in the future.”

In other words, we have been flagrantly violating the fundamental principle of sustainable development put forward in 1987 by the Brundtland Commission: To meet the needs of the present without compromising the ability of future generations to meet their own needs. Or to use an older concept, we have forgotten that we do not inherit the Earth from our parents, but borrow it from our children.

Of course it’s not just the fossil fuel industry that is causing harm. Other major industries behind these global ecological changes also bear a heavy responsibility – as do we all, ultimately, in that we use and enjoy their products. The focus on making money now and to heck with the future is grossly irresponsible. The legacy is a depleted and impoverished natural environment for our descendants, an infringement of their right to a healthy environment.

But I cannot think of a better example of a group that is intent on harming the health of their descendants than the fossil fuel industry and their political allies and supporters. We know that our present path will take us well beyond a global temperature increase of 20C. We also know that much of the carbon in the ground, in the form of coal, oil and gas, will need to stay there if we are to avoid this.

So continuing to push for the use of fossil fuels, leaving in place tax breaks and subsidies to the fossil fuel industry and opposing carbon taxes and other measures to limit fossil fuel use is the height of inter-generational selfishness and irresponsibility. The defence of the industry in Canada – which basically amounts to ‘other people around the world are being irresponsible, so we should be irresponsible too’ is an abdication of leadership.

The approach of these fossil fuel advocates is also harmful to those who make their living from fossil fuels, because in going to the wall for the industry, Kenney and his fellow-travellers around the world delude not only themselves but these workers that the industry must be there and must grow.

In doing so, they are postponing the vitally important work of creating a socially just transition away from fossil fuels for these workers, with the training, support and other measures they and their communities will need. That will only make the changes, when they do happen, that much more sudden and wrenching.

What we all need to do, including Kenney, Ford and the rest of the fossil fuel support clique, is to follow the advice of Jonas Salk, creator of the polio vaccine, who said “Our greatest responsibility is to be good ancestors”. Being responsible ancestors does not include mortgaging the health of future generations and compromising the ability of those future generations to meet their own environmental, social and economic needs.

Acting as responsible ancestors means, first of all, recognising the issue of intergenerational justice, the right of our descendants to a healthy environment. It means seeking to create high levels of human and social development for this generation in a way that is socially just and within the limits of the Earth. It does not mean continuing to boost the fossil fuel industry, but seeking the quickest possible transition to a low-carbon future.

© Trevor Hancock, 2019


How do tobacco execs sleep at night?

How do tobacco execs sleep at night?

Dr. Trevor Hancock

22 October 2019

701 words

For many years, I have wondered how the leadership of the tobacco industry – the members of the Boards of Directors and senior executives who work to maintain or expand the sales of their lethal products – sleep at night? And I also wonder why they are still accepted as members of our community and national organisations, why they are not ostracised, made unwelcome in civilised society.

Because, let’s face it, these are not nice people; they are peddling a drug and working to get young people socialised to smoking and addicted to nicotine, in part by moving into other areas that relate to and feed into their products – vaping and marijuana. Yet they know full well their products, when used as intended, result in millions of deaths – the World Health Organisation estimates tobacco kills about 8 million people annually, worldwide.

The tobacco industry also causes thousands of deaths and a vast burden of disease in Canada; I noted in a November 2018 column that tobacco causes 17 – 18 percent of all deaths in Canada, around 40 – 45,000 people annually. This is almost ten times the number of deaths from opioid drugs, which was 4,588 in 2018, according to an August 2019 Canadian government report.

This should hardly come as news to the tobacco industry leadership. The evidence on the lethality of their product is not in doubt, and in fact has been clear for two generations, since the US Surgeon General’s report in 1964. So they can hardly claim they do not know that tobacco kills and sickens. Yet they continue to produce and market it.

In a 2014 report marking the 50th anniversary of that landmark report, the US Surgeon General was blunt: “The tobacco epidemic was initiated and has been sustained by the aggressive strategies of the tobacco industry, which has deliberately misled the public on the risks of smoking cigarettes”. And the report went on to say ”The industry used its influence to thwart public health action at all levels and fraudulently misled the public on many issues, including whether lower-yield cigarettes conveyed less risk to health and whether exposure to second-hand smoke harmed non-smokers. Undoubtedly, these actions slowed progress in tobacco control.”

So why do we tolerate the presence of the tobacco industry leadership in society and in our community organisations? Why are they not treated as social pariahs? Do we really want people like this on the Boards of our local community organisations, service clubs and charities? Should they be welcome in your church, temple, synagogue or mosque?

But we need to look beyond the senior management of the tobacco industry: Who is investing in this lethal industry, in the hope of making money? Well, indirectly, we all are, through the Canadian Pension Plan. Many of us are probably also invested in tobacco through our work or private pension funds and RRSPs.

The CPP reports that as of 31st March 2019 it had over $1 billion directly invested in large tobacco companies, including $581 million in Phillip Morris International, $479 million in the Altria Group, which “holds diversified positions across tobacco, alcohol and cannabis”, including Philip Morris USA as well as 35 percent of the vaping company Juul, and $118 million in Japan Tobacco.

The good news is that it seems you and I are no longer directly invested through the CPP in British American Tobacco, Imperial Tobacco or Reynolds, which was the case in 2017. However, it is likely that the CPP has much more invested in the tobacco industry through investment portfolios in which it has holdings.

But why is the CPP investing in this unacceptable industry? Doubtless they and the tobacco industry leadership will tell you this is a legal product, and they are just doing their job – but this is not simply an issue of legality, it’s an issue of morality. It’s about producing and marketing a product that is known to be lethal, creating a new generation of users and addicts, causing almost ten times as many deaths as the opioids epidemic that we are so concerned about.

So how do the leaders of this industry and those that invest in it live with themselves? How do they sleep at night?

© Trevor Hancock, 2019


A lunatic mainstream or a sensible fringe?

A lunatic mainstream or a sensible fringe?

Dr. Trevor Hancock

16 October 2019

701 words

In his October 13th column Lawrie McFarlane suggested the Greens and the NDP have embraced “radical notions that place them far outside the mainstream” and that they “are in danger of becoming a lunatic fringe”. This is a quite commonplace representation of both parties from the right wing of the political spectrum.

But as I see it, it is the mainstream that has become lunatic, while the Greens and the NDP represent in some senses a conservative fringe. I recall someone noting many years ago that it is conservatives who are radical today, in that they want to radically alter the environment through economic development, growth and deregulation, while it is the environmentalists who are the true conservatives, the people who want to conserve the environment.

So let’s look at some of the ways that the mainstream is in fact radical, if not indeed lunatic. Given that the the natural environment is the source of all that matters for our life and health – oxygen, water, food, materials, fuels, waste decomposition, protection from UV radiation and so on – threatening the viability of the natural environment is insane, while protecting and conserving it is eminently sensible.

Then there is the very mainstream concept of economic growth. It is an issue I have addressed before, so I will not repeat myself at length. But Kenneth Boulding, a former President of both the American Economic Association and the American Association for the Advancement of Science, put it very simply: “Anyone who believes exponential growth can go on forever in a finite world is either a madman or an economist”.

So continuing to push for economic growth, where that means further harm to the Earth’s natural systems, further depletion of vital natural resources and further extinction of the species that make up the web of life – as it does in the current mainstream model of development – is mad.

Another example of mainstream lunacy is the commitment to fossil fuel use and even expansion. The two mainstream parties – Liberals and Conservatives – are both guilty of this piece of folly. But it is the Conservatives who are the most lunatic: Look at the pro-fossil fuel and thus pro-climate change policies not only of the federal Conservatives but their provincial partners in Alberta, Saskatchewan, Manitoba and Ontario.

So if the mainstream is lunatic, let’s look at some of the Green and NDP ideas that are considered fringe, radical or even lunatic but that in fact seem entirely reasonable and indeed sensible ways to improve health and wellbeing. Among them are free pharmacare and dental care for at least some if not all of the population, along with free or subsidised child care and university and college tuition.

Are these ideas really that radical, or even ‘lunatic’? Well, maybe, if your model is the USA, but not if we look to Europe. A 2016 article in the Canadian Family Physician noted that “Canada is unique among highly developed countries in its curious exclusion of prescription drug coverage from its universal health insurance program”.

As to family-friendly policies, “Sweden, Norway and Iceland occupy the top three places in the league table of national, family-friendly policies” according to a 2019 report from Unicef, based on 2016 data, while all three, and many other European countries, have childcare enrolment between age 3 and school age of at least 90 percent. Recent data for Canada is hard to come by, but is lower than that.

These and other programs would be paid for by a combination of re-directed spending and increased taxes on high income earners and corporations. Here the NDP and Green Party plans are similar: Close tax loopholes and subsidies that favour the wealthy and large corporations and increase taxes on corporations and the highest income earners – hardly radical. In fact, the top personal income tax rate is higher in Austria, Denmark, France and Japan, while even after allowing for provincial corporate taxes, Canada’s corporate tax rate in 2018 was still lower than in Australia, Belgium, France, Germany and Japan.

So just who are the wild-eyed radicals, who are the lunatics here – and who are the sensible ones, the ones that seek to conserve the environment and maximise human and social development?

© Trevor Hancock, 2019



Elect a health and wellbeing government

Elect a health and wellbeing government

Dr. Trevor Hancock

9 October 2019

700 words

Since 1948 the World Health Organisation has defined health as a state of complete physical, mental and social wellbeing. While full health in that sense may be unattainable, it remains a powerful aspiration. Who does not wish for a long life in good health for themselves, their loved ones and friends – and by extension for everyone in their community?

I recognise that health and wellbeing may not be the only value that Canadians care about, but it surely is one of the most important. And who does not expect their governments, at all levels, to help people thrive by bringing in policies and programs that both protect us from harm and create supportive physical, social and economic environments. Such policies make it easier for us to make healthy and sustainable rather than unhealthy and unsustainable choices.

In an earlier column on this theme I suggested two fundamental principles of public health: Ecological sanity and social justice. So in broad terms, if you are interested in the health of this and future generations, support the party that has the most ecologically sane and socially just platform. Here are some specific areas where you might look for evidence of a commitment to wellbeing.

First, food and agriculture, because we are what we eat, and because this sector is a major contributor to green house gases and our overall ecological footprint. Given the importance of food for our health, you would think it would be an important concern for Agriculture and Agri-Food Canada (yes, that really is its name!). Think again. The Department says its mission is to provide “leadership in the growth and development of a competitive, innovative and sustainable Canadian agriculture and agri-food sector”. Health gets merely a passing reference, and hunger is ignored.

We need an integrated national food and agriculture policy that puts health and the elimination of hunger in Canada at the centre. Within such an overall policy, the Department should be ensuring that the agricultural sector supports the new Canadian Food Guide, which closely reflects both Michael Pollan’s advice – “Eat real food, not too much, mostly plants” and the Lancet-EAT Commission’s report on a healthy and sustainable diet. A low-meat diet, combined with a less intensive, organic and ecological system of agriculture will benefit both human and ecosystem health.

Second, energy policy. Any government that takes seriously the health of today’s young people and future generations – rather then the profits of their fossil fuel industry supporters – will be leading a rapid transition to a low-fossil fuel future. A good place to start would be a commitment to no further expansion of existing fossil fuel infrastructure (so no tarsands expansion and no new pipelines) and a very rapid shift of all fossil fuel subsidies and tax breaks to the conservation and clean energy sector.

Third, transportation. The health and environmental benefits of active transportation (biking and walking) and public transit are very well documented and very significant. So while the federal government does not have a large role in urban planning, look for parties that will make significant investments in active transportation and transit. Just as important, a health and environment-conscious government will stop all investment in infrastructure that supports further utban sprawl (such as the very dumb McKenzie interchange).

Fourth, economic policy. Greta Thunberg said it well at the UN: “all you can talk about is money and fairy tales of eternal economic growth”. Conventional economic growth is what has gotten us into this mess; beware any party that thinks we can just carry on with more ‘business as usual’ growth. As I noted in a June column, New Zealand has adopted a Wellbeing budget, “placing the wellbeing of New Zealanders at the heart of what we do”, according to the Minister of Finance. We need this in Canada.

So as you contemplate where to place your vote in this federal election – or at any election, for that matter – you might ask which of the parties or candidates comes closest to the sort of policies I have described here. They are the ones that are most likely to improve the overall wellbeing of Canadians, especially those with the worst health, in this and future generations.

© Trevor Hancock, 2019




Poverty and health is an election issue

Poverty and health is an election issue

Dr. Trevor Hancock

1 October 2019

702 words

Forty years ago I wrote about two principles that I considered fundamental to the health of the population: Ecological sanity and social justice. If we do not pay attention to these principles and what we now call the ecological and social determinants of health, the health of the population will be seriously harmed.

Last week I wrote about the first of these as an election issue – we are acting in Canada in an ecologically insane manner, and it threatens our health, especially the health of today’s young people. Today I turn to the issue of social justice, especially as represented by poverty, where yet again young people are the most at risk of harm.

It is hardly a secret, nor a revelation, that poverty is bad for health. So you would think any government, and any party wanting to be the government, would make this an important area of focus. But persistent inequality surely tells us that the Liberals and Conservatives – who between them have always formed the government in Canada – simply don’t care about poverty and its harmful effects upon the health of Canadians. If they did, they would have done something to fix it.

As it happens, the Victoria Foundation released its excellent Vital Signs report this week, so we have a good picture of poverty in Victoria. Compared to the overall poverty rate in BC as a whole and in Canada we do quite well, but that is hardly a basis for satisfaction or complacency. The overall poverty rate for Greater Victoria was 14 percent – one in seven people here live in poverty!

The rate among children is higher, at 16 percent, and double that for single parent families, almost one in three of whom live in poverty. So much for the federal Parliament’s pledge to eliminate child poverty by the year 2000! The lowest rate is among seniors, at 10 percent – which raises the question of why it seems to be OK for children to experience more poverty than their grandparents.

Moreover, living above the poverty line is hardly an easy life. BC’s minimum wage under the NDP has now gone up to $13.85 an hour, just enough to lift a single person working full time for a full year above the poverty line. But the living wage – the hourly wage needed for a family of two working parents with two young children if they are to maintain an adequate quality of life in this region – is $19.39 an hour.

In addition to these direct measures of poverty, we must also be concerned about the degree of inequality in society. The 2016 report by the Canadian Index of Wellbeing (CIW) program at the University of Waterloo notes: “Unequal income distribution is detrimental to the wellbeing of Canadians because it is related to financial instability and poorer economic growth”. Unequal distribution of income is measured by the Gini coefficient, where “a score of zero would represent a perfectly equal distribution of income” – so the lower the score the more equal the distribution.

Using Statistics Canada data, the CIW reports the Gini coefficient in Canada has risen from 0.290 in 1994 to hover between 0.312 and 0.322 since 2000; it was 0.319 in 2014. The OECD reports it was 0.31 in 2017 not as unequal as the UK (0.36) and the USA (0.39), but much more unequal than Finland and Belgium (0.27) or Norway, Denmark and Iceland (0.26).

But the evidence is clear that rich countries that have lower levels of inequality do better on a wide range of health and social outcomes. In other words, reducing poverty is good for the country as a whole, for everyone, not just for those living in poverty.

These levels of poverty and inequality are a disgrace in a country this rich and supposedly socially aware. So ask your candidates what is your party’s plan – not hopes and wishes and intentions, but actual plan – to eliminate child poverty in Canada, and to reduce levels of inequality and poverty to be at least equal to the best performing countries in the OECD. Because if they don’t have such a plan, it is clear they do not take the health of Canadians seriously.

© Trevor Hancock, 2019