Author: Dr. Trevor Hancock

21 June 2017

700 words

This is National Aboriginal Day (June 21^st) and we are just 10 days away from Canada Day. So it is a suitable time to reflect on Canada 150, or – as Inuk film-maker Alethea Arnaquq-Baril rightly pointed out in one of the recent Walrus Talks – Canada 15,000. After all, before the two ‘founding nations’ of Canada appeared on the scene back in the 16^th century, the real founding nations had been here some 14,000 years.

Just as Indigenous people were not celebrating in 1992 the 500^th anniversary of the ‘discovery’ of the Americas by Columbus, I can’t imagine there will be many celebrating Canada’s 150^th birthday. And who can blame them? The harm inflicted on the Indigenous people of the Americas in the past 500 years has been devastating, as has been the history of the relationship between Canada and its Indigenous people since 1867, as demonstrated in the report of the Truth and Reconciliation Commission.

While we can’t undo that history – and indeed need to face it and accept it – we can create a different story for the next 150 years, and there is no better time to be thinking about this than right now. Moreover, in doing so, we can acknowledge an approach credited to Indigenous ways of thinking, namely to plan for the 7^th generation. Since a generation is roughly 20 – 25 years, 7 generations takes us out about 150 years.

As a long-time planner and futurist, I am well aware of the difficulty of planning for a time horizon of 150 years, or even 50 years. Sadly, our political cycles do not reflect the reality of the seventh generation viewpoint, indeed they barely reflect the next generation. But here are some ways to think about what connects the present to the next 100 years or more, and why today’s decisions are so important for the long term.

First, consider that the buildings and infrastructure we create are with us for 50 – 100 years or more. The suburban sprawl we have created since the 1950s still shapes our way of life, our transportation systems, our energy use and our impacts on human and ecosystem health, and will do so for decades to come.

Next, recognize that a female foetus in her mother’s womb today contains within her developing ovaries the eggs that one day, some 20 years hence, will be her children. If those infants live to be 80 – our current life expectancy, although by no means predictive – then the mother of that yet-to-be-born infant carries within her the eggs that will be her elderly grandchildren some 100 years ahead.

Some of our most toxic pollutants are called persistent organic pollutants because they were designed to be persistent; unfortunately, this means that we and our descendants will carry body burdens of them throughout our lives.

The carbon dioxide we are spewing out – and that Donald Trump wants to increase – has an atmospheric lifetime of up to 200 years, according to the Intergovernmental Panel on Climate Change, and will thus continue to overheat the planet. And the species extinctions we are creating at 10 – 100 times the base rate over the past 10,000 years, are forever.

But perhaps the new BC government – more attuned as it is to environmental sustainability and social justice – could use the opportunity afforded by Canada 15,000/150 to initiate a conversation – in partnership with Indigenous people in particular – about our long-term responsibilities and our duty to future generations.

Fundamentally, it is unethical for us to consume the resources and harm the natural systems that our descendants will depend upon for their own wellbeing; this is the ethical principle of intergenerational justice. Arguably, it is also unethical for us to appropriate ecosystems and resources that other species require for their own survival; the Earth is not ‘ours’ alone, we share it with many other species, many of which we depend upon for our own survival.

So – much as we are doing here in Victoria with our ‘Conversations for a One Planet Region’ – as we mark Canada 15,000/150, lets think about the next 150 years, the next seven generations, and how we ensure a more healthy just and sustainable life for them.

© Trevor Hancock, 2017

 

Dr. Trevor Hancock

10 June 2017

701 words

The new BC government – assuming things work out as expected – will mark a significant departure from any previous government we have seen in Canada. The presence of the Greens as partners with a minority NDP government should lead to a significant re-thinking of the direction of society and the role of government.

This is because the Greens mark a real break with the economic and social consensus that has dominated politics on both left and right for the past century or more. This consensus has been that we need to exploit the Earth’s resources to fuel economic growth, which in turn will fuel human development and progress, without any serious consideration of the long-term implications of this.

While there are important social policy distinctions between left and right, until recently there have not been important differences from the Earth’s point of view. Both socialist and conservative governments in Canada and around the world have been keen to industrialise and to exploit the Earth, with differences more in the realm of how equitably the benefits and costs are distributed, and how much or how little environmental protection is offered. We only have to look at the current positions on the Kinder Morgan pipeline to see this; it is supported by the right wing ‘Liberals’ in BC, the federal Liberals and the Alberta NDP.

But now we have both the BC NDP and the BC Greens opposing it. This is promising, but that approach has to become broader and deeper if we are to make the transition we need to make from an economic system that increasingly does more harm than good to a system that improves human and ecosystem health at the same time.

This is what really makes the Greens different; they are, as an old German Green Party slogan put it, ‘neither left nor right, but ahead’. The focus of Green politics and economics is on ecologically sustainable human and social development rather than economic growth, and on such ideas as a steady state economy (my topic last week) and alternate measures of progress to GDP, such as the Genuine Progress Index.

One of the key problems that we have to overcome if we are to successfully move to a sustainable system of social and economic development is the short-term thinking that dominates in both government and business. Too often, government policy is dictated by the need for quick (and thus often ‘dirty’) fixes before the next election, with scant regard for long-term impact, while business too is often focused on the short-term bottom line.

So if I have one key wish for this new government, it is that they take a leaf from the Welsh Assembly and pass a Wellbeing of Future Generations Act (see http://thewaleswewant.co.uk/sites/default/files/Guide%20to%20the%20WFGAct.pdf for a succinct and accessible overview). The Act was passed in 2015 and it is intended to “improve the social, economic, environmental and cultural well-being of Wales” so as to “give future generations a good quality of life”.

The Act requires governments to think about the long-term impacts of their actions. Crucially, it requires all Ministers, as well as local authorities, health boards and a number of other public bodies, to “carry out sustainable development” and establishes a ‘sustainable development principle’ that they must follow; they “must act in a manner which seeks to ensure that the needs of the present are met without compromising the ability of future generations to meet their own needs”.

There are seven ‘Wellbeing Goals’ (a Wales that is prosperous, resilient, healthier, more equal, globally responsible, with cohesive communities and a vibrant culture) and the Act “makes it clear the listed public bodies must work to achieve all of the goals, not just one or two”.

The Act also requires transparency and accountability; the Ministers and others must “set and publish well-being objectives” for all seven goals and must publish an annual report on their progress. They are also subject to review by the Future Generations Commissioner (who is “a guardian for the interests of future generations in Wales”) as well as the Auditor General.

What’s not to like in this? If Wales can do it, there is no reason BC cannot; future generations will be very grateful.

© Trevor Hancock, 2017

 

Dr. Trevor Hancock

30 May 2017

696 words

Kenneth Boulding was one of the founders of General Systems Theory and at various times was President of the American Economic Association, the Society for General Systems Research, and the American Association for the Advancement of Science. So when he wrote that “Anyone who believes exponential growth can go on forever in a finite world is either a madman or an economist”, he knew what he was talking about.

Not so our political and corporate leaders and the bulk of the economic profession, who are still wedded to the pursuit of economic growth as their foundational approach to life, public policy and corporate profit. So let’s see just how mad the pursuit of economic growth is.

In our report for the Canadian Public Health Association on the public health implications of global ecological change, my colleagues and I did a simple extrapolation of two of the three key forces driving global ecological change; population growth and economic growth. We asked, what would be the impact on the Earth’s resources and natural systems of current levels of population growth combined with 3 percent economic growth (a seemingly common target) over the lifetime of someone born this year?

In an 80-year lifespan (roughly the average today in Canada and other high income countries), one percent annual population growth would mean a 2.2-fold increase in impact, while a three percent annual increase in real GDP would result in a 10.6-fold increase. Multiply them together and we are looking at a 23-fold increase in impact by the end of the century.

But already humanity uses the equivalent of 1.6 planet’s worth of biocapacity (the Earth’s ability to produce renewable resources on an on-going basis and to absorb wastes) and we are disrupting major Earth systems; the prospect of increasing that impact 23 times is untenable.

Now admittedly, not all that economic growth translates into growth in material consumption, hence the suggestion that we can ‘de-couple’ economic growth from growth in uses of energy and other resources and production of wastes. But even if our technology becomes 5 times more efficient, as some suggest it can, we are still looking at a more than 4-fold increase.

We in high-income countries have a 3 or 4-planet ecological footprint. So even if we can be more efficient through technology, does anyone in their right mind imagine that we can or should increase that to more than 12 – 16 planet’s worth by the end of the century?

Hence the interest in a long-neglected but important economic approach: a steady-state economy. Dan O’Neill, an ecological economist at the University of Leeds, UK – but a Victoria native – has focused his work on this concept. At its simplest, O’Neill argues, “it is an economy where resource use is stabilized within environmental limits, and the goal of increasing GDP is replaced by the goal of improving human well-being. It’s an economy where the goal is better lives, not more stuff.”

A number of changes are needed to achieve such an economy, he notes, including policies to conserve natural resources, stabilize population, reduce inequality, fix the financial system, create jobs, and change the way we measure progress. These ideas are explored in the book Enough Is Enough: Building a Sustainable Economy in a World of Finite Resources, which he co-authored with Rob Dietz, and which was recently made into a short documentary film.

O’Neill also co-leads a major European project on ‘Living Well Within Limits’, which is part of the European Union Environment Action Programme to 2020. The Programme’s long-term vision is that “in 2050, we live well, within the planet’s ecological limits”. His project will analyse and model the energy requirements of well-being, an important contribution to understanding how to reduce resource use to be within critical planetary boundaries, while improving human well-being.

These ideas are extremely relevant to the topic of Victoria as a One Planet Region, which we have been exploring in a series of ‘Conversations’ since January. Happily, Dan O’Neill is currently at UVic on sabbatical, and will be presenting his ideas and his latest work on June 12^th, 5 – 7 PM, in the Auditorium (A240) of the HSD Building at UVic. All are welcome.

© Trevor Hancock, 2017

I have been writing this column without a break for over two years: So I am taking a break for vacation and will be back in June.

Reverse 45 years of neglect of health centres

Dr. Trevor Hancock

17 April 2017

703 words

In the late 1970’s I was one of two family physicians in a brand-new community health centre (CHC) in Toronto. We were on salary and worked with a nurse-practitioner (NP) and a community board. These were the early, heady days of CHCs, with several CHCs established at the same time across Toronto and elsewhere.

It wasn’t easy, we were met with suspicion, resentment and some times outright hostility from the medical profession, for whom we were traitors, undermining physician autonomy and the fee-for-service system while bringing in NPs. But we were passionate, idealistic and committed to implementing the model proposed just a few years before in the Hastings Report.

This Report, released in 1972, was commissioned by Canada’s Ministers of Health and led by Dr. John Hastings, a distinguished professor of health administration at the University of Toronto. Its key recommendation was “the development . . . of a significant number of community health centres . . . as non-profit corporate bodies in a fully integrated health services system”.

The authors described a CHC as “a facility . . . enabling individuals and families to obtain initial and continuing health care of high quality . . . provided in an acceptable manner through a team of health professionals and other personnel working in an accessible and well-managed setting”. What’s not to like about that?

Ideally a CHC would be responsible for providing care to people living in a defined geographic area, coordinating their primary care with home and community care. Facilitated by a community board, the CHC would become involved with public health, various community-based organizations and local government in efforts to improve the overall health of the community.

But while a few CHCs were established, the model did not become widely adopted, in large part because of the opposition noted earlier. In fact CHCs mostly became seen as a way to provide health care to low income and disadvantaged populations. For example, there are only three CHCs here in Victoria, of which one is for adults over the age of 55 and another is for people who are homeless, vulnerable and living on very low incomes; only one, the Victoria Community Health Cooperative, is for the general population.

Thus average Canadians did not get to reap the benefits of this superior form of health care. This is a shame because a 2012 report from the Canadian Foundation for Healthcare Improvement noted “despite significant progress since 2000, the performance of Canadian primary care trails that of many other high-income countries”.

Fast forward 40 years and there is a growing interest in CHCs, including a much more favourable attitude amongst family physicians. Moreover, there is growing body of evidence that the belief espoused by the Hastings report – “that some shift from the present emphasis on acute hospital in-patient care to other forms of health care, including types of community health centre, offer a means of slowing the rate of increase in health services spending” – is correct. But unfortunately CHCs in BC have only received weak support from the government and generally lack core operational funding.

A newly-released position paper from the BC Association of Community Health Centres (BCACHC), which speaks for the 29 CHCs in BC, cites evidence that CHCs have been shown to reduce avoidable use of hospital emergency rooms, improve accessibility and comprehensiveness of health and social services in rural areas, and enhance the accessibility and effectiveness of mental health and addictions programs – all of which are Ministry of Health priorities.

Importantly, last month the BC Legislature’s Liberal-dominated Select Standing Committee on Health released a report in which it supported many of the elements of CHCs. Specifically, they recommended implementing “a community health centre model of care” and providing “adequate operational and capital funding for new and existing community health centres throughout the province”.

In an online petition to all three major party leaders, the BCACHC calls on the next government to “invest in 20 new community-governed Community Health Centres throughout British Columbia” by 2020. It’s way past time the province did so.

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I have been writing this column without a break for over two years: So I am taking a break for vacation and will be back in June.

© Trevor Hancock, 2017

 

 

Child poverty is outrageous and unhealthy

Dr. Trevor Hancock

10 April 2017

699 words

Canada is a wealthy country and within Canada, BC is a wealthy province. And yet we have levels of child poverty that are shameful, that exert a terrible toll on the health of children, and that blunt our human and social development. If it is true that the worth of a society is best judged by the way in which it treats its most vulnerable, then we fail miserably.

In its November 2016 BC Child Poverty Report Card, First Call, the BC Child and Youth Advocacy Coalition, reported that one in five children – one in five! – live in poverty. Even worse, almost half of the children living in single-parent families – most of them single-mother families – are living in poverty. Most damning of all, child poverty rates have barely budged in recent years, demonstrating a complete absence of political commitment to fix the problem.

In 1989, the House of Commons resolved to eliminate child poverty by the year 2000, which turned out to be a cruel hoax. BC’s child poverty rate climbed from 15.5 percent in 1989 to 25.3 percent in 2000. Between 2004 and 2007 it dropped to about 20 percent and has been around there ever since. In essence, we have come to accept that this level of child poverty is just a normal part of life.

Yet this is a fixable problem; other advanced industrial nations have almost eliminated child poverty. A 2016 OECD report, using 2013 data, notes “In Finland and Iceland the child income poverty rate is only around 5 – 6%, while in Denmark it is less than 3%”; using that measure of poverty, Canada’s rate is around 16 percent. So clearly, as my late friend and colleague Clyde Hertzman used to remark, “it doesn’t have to be this way.”

There is quite a price to be paid for keeping it that way. It is paid most of all by children living in poverty, and is a price they will pay for the rest of their lives. But the rest of society also pays a price in lost human potential, lost economic production and increased costs for health, social assistance and other supportive services.

Working at UBC, Clyde was the founder of HELP – the Human Early Learning Partnership – which developed an international reputation for its work on what made children healthy. So much so that when the World Health Organisation established a Commission to examine the social roots of health and illness, Clyde was asked to head up one of eight ‘knowledge networks’, the one on early child development (ECD).

The network’s final report to the Commission noted that ECD “strongly influences basic learning, school success, economic participation, social citizenry, and health” – that is a pretty broad swathe of social benefit. They also noted that inequality in the availability of ‘socio-economic resources’ (in other words, poverty) resulted in inequalities in ECD. On the other hand, “any additional gain in social and economic resources to a given family results in . . . gains in the developmental outcomes of the children in that family”.

In a nutshell, poverty harms early child development, which harms social and economic development over many decades. Thus they concluded “investment in early childhood is the most powerful investment a country can make, with returns over the life-course many times the amount of the original investment.”

 

Such investments would include “family-friendly social protection policies that guarantee adequate income for all, maternity benefits, financial support for the ultra-poor, and allow parents and caregivers to effectively balance their time spent at home and work” as well as policies that guarantee “universal access to a range of early child development services: parenting and caregiver support, quality childcare, primary healthcare, nutrition, education, and social protection”.

That is an agenda for healthy children and adults, healthy communities and a healthy society. One would think that a wise government would take heed of this advice, especially as it came from a world expert right here in BC, and that a Premier and a government committed to a Family First approach would adopt such policies. Sadly, that has not been the case, and as a result, children and our whole society continue to pay the price.

© Trevor Hancock, 2017

 

‘Mincome’ is pro-health and against poverty

Dr. Trevor Hancock

2 April 2017

702 words

Last week I wrote about the health, social and economic benefits of a poverty reduction plan for BC. Not unreasonably, a reader challenged me to explain how we could afford that. “Just what price tag would you set on the actions you propose?”, he wrote, “Then we could move on to that tricky part about how well — or if — the plan works.” Fair enough, so here goes.

I wrote about the costs in my column on January 7^th 2015. As that is more than two years ago, I will repeat some of it here. In a 2011 report the Canadian Centre for Policy Alternatives looked at the total costs of poverty in BC. They estimated that overall, the annual direct costs to government from increased costs for health care, justice services and foregone tax revenues were $2.2 – 2.3 billion. Note that this is an understimate, because estimates of the costs of social services were not available.

The added health care costs alone related to poverty were estimated to be $1.2 billion, based on the potential savings in reduced health care utilisation if people in the lowest 20 percent of income had the same health status as those in the next 20 percent, which is only a modest change.

When they added up all the costs, including costs due to lost production, lost income and lost tax revenues attributable to poverty, they concluded that poverty costs between $8.1 and $9.2 billion per year. This is more than double the $3 – 4 billion they estimated it would take to markedly reduce poverty by investing in a poverty reduction strategy that would end homelessness and hunger, ensure access to affordable housing and child care, and improve pay and working conditions for people in low–wage jobs.

So on the face of it poverty is so expensive that we can’t afford it, and there might be an economically beneficial alternative. This seems like an idea that any fiscally responsible government would consider worth invesigating and testing, not just dismissing out of hand. Which is presumably why all the other provinces have developed some form of a poverty reduction plan.

One possible solution was tested in Canada 40 years ago – and seemed to work. Between 1974 and 1979 the federal and Manitoba governments collaborated on a project – Mincome – to provide a guaranteed annual income (GAI) to the residents of the town of Dauphin MB. The GAI is a form of negative income tax or refundable tax credit; its proponents claim it is particularly effective in aiding the working poor and is simpler and cheaper to administer than the many existing and overlapping programs. Regrettably, the research on Mincome was shelved – the data were collected but not analysed – amidst waning political support.

Mincome was available to all the roughly 10,000 people of the town and the 2,500 people in its rural municipality. However at any one time, “only about a third . . . of families qualified for support and many of the supplements would have been quite small”, according to Professor Evelyne Forget, an economist in the Department of Community Health Sciences at the University of Manitoba, who came across this forgotten study about a decade ago and analysed it.

In a report published in Canadian Public Policy she concluded “a relatively modest GAI can improve population health, suggesting significant health system savings”. Specifically, she found an “8.5 percent reduction in the hospitalization rate for participants relative to controls, particularly for accidents and injuries and mental health”, and she also found that “participant contacts with physicians declined, especially for mental health”. She noted that the reduction in hospitalisation would have amounted to savings of $4.6 billion annually in Canada in 2010.

Also important was the finding that people did not stop working – except for new mothers and teenagers. Given the health and social benefits of mothers spending more time at home with their infants and adolescents continuing on into grade 12, these are desirable outcomes.

Small wonder that Quebec has explored the idea, while Ontario is actively considering testing a basic income in several communities, based on a report commissioned from former Conservative Senator Hugh Segal. Would that the BC government were that forward-thinking and thoughtful.

© Trevor Hancock, 2017

 

BC’s pro-poverty policy is sickening and costly

Dr. Trevor Hancock

27 March 2017

703 words

Last week my students were discussing public health ethics. One group pointed out, correctly, that doing nothing is a policy decision. What then are we to make of the BC government’s persistent policy, over the past 15 years, to do little or nothing about poverty reduction? In effect, their decision to do nothing is a ‘pro-poverty’ policy; it seems they prefer to prolong and deepen poverty, and to fail to offer adequate relief for those living in poverty, in an attempt to force them into the low-wage workforce.

BC remains the only province that has not adopted a poverty reduction plan, and seems to glory in having a low minimum wage and low rates of social assistance. In fact BC, a wealthy province, has the second highest rate of poverty in Canada at 13.2 percent – almost 1 in 7 people – according to a January 2017 report from the Canadian Centre for Policy Alternatives (CCPA).

The report notes that “BC’s minimum wage was frozen at $8 an hour for nearly a decade between November 2001 and April 2011”. While it has increased since then, someone working full-time at minimum wage in BC today is about $3,500 below the poverty line for a 35-hour week and about $750 below if they work a 40 hour week. So even if they buy into the government’s mantra that the best social program is a job, they are going to live in poverty unless they get a second job or work overtime (if it’s available).

Social assistance rates are even more impoverishing; rates have been frozen since 2007 and are now the third lowest in the country, at $610 a month for a single person, in a province that has a high cost of living. According to a 2015 Caledon Institute report cited by the CCPA, a single person on welfare in Metro Vancouver in 2015 would have reached only 40 percent of the poverty line, while a single parent with one child – mainly women – would reach 66 percent of the poverty line.

Moreover, many of the jobs that are being created in BC are in part-time, low-wage work. In its submission to the 2017 Budget Consultation, the CCPA pointed to Statistics Canada data showing that in the first quarter of 2016 “among the ten occupations with the most job vacancies in BC . . . five paid less than $12/hour”.

As they drily note, “these are not family-supporting wages”, while Irene Lanzinger, president of the B.C. Federation of Labour commented to the CBC in January that “We have not seen good, permanent full time family-sustaining jobs created by the [province’s] job plan,”

Not only is the lack of attention to poverty an ethical lapse, it does not make economic sense, because poverty is associated with higher levels of ill health, which costs the health care system a great deal in additional care.

A 2016 report from BC’s Provincial Health Services Authority reported that people who live in local health areas with high socio-economic status (SES) “are expected to live nearly four years longer than people living in low SES areas” and that “people in the highest income group reported significantly more favourable rates than those in the lowest income group for a number of indicators” of health.

Not surprisingly, a 2016 report from the Public Health Agency of Canada on the economic costs of health inequality noted that “health care costs generally decline as income rises”. Overall, they found that in 2007-8 “socio-economic health inequalities cost Canada’s health care system at least $6.2 billion annually” – and they were only looking at about a quarter of all health spending. This finding was echoed in a 2015 report from the Canadian Institute for Health Information, which also noted “there has been minimal progress in reducing the health gap between lower- and higher-income Canadians over the past decade”.

A government truly concerned about the health of both its citizens and its economy and the financial sustainability of its health care system needs to act on the understanding that poverty is both sickening and expensive, and that investing in poverty reduction is a smart and healthy decision. Let us hope the next government is sufficiently wise to see this.

© Trevor Hancock, 2017

 

Compassionate communities support those who are dying

Dr. Trevor Hancock

20 March 2017

694 words

I have been involved recently with people and organisations working in the area of hospice and palliative care. What I found intriguing was their interest in a public health approach to death and dying. As noted by Dr. Alan Kellehear, a UK-based social scientist working in this area, “to achieve optimal health and wellbeing in the 21st century a community engagement approach to health must extend its active concern to the end-of-life itself”.

On the face of it, adopting a public health approach in palliative care may seem odd, since public health is focused on preventing death and disease. But in the field of prevention we talk about several levels of prevention, beginning with ‘primordial prevention’ – looking upstream at the large environmental, social, economic and cultural factors that shape our health – and primary prevention. The latter is focused on preventing a disease or injury from occurring in the first place; think of immunisation, or creating a non-smoking society.

But there is also a less well-known form of prevention: Quaternary prevention. This is concerned with preventing harm within health care, including preventing an ‘unhealthy’ death. That puts us in the same business as palliative care and hospices. But they are also interested in public health for another reason; our community orientation, and especially our interest in creating healthy communities.

Pallium Canada, a national organization created to improve the quality of hospice and palliative care services, notes that a public health approach to palliative care “takes the responsibility . . . from a few highly trained specialists to a community that considers it ‘everybody’s business’”. This approach is known internationally as Compassionate Communities, a concept championed since the 1990s by Dr. Kellehear.

In a 2013 article, he reported that a survey of more than 200 UK palliative care programs found a significant number of them were developing ‘compassionate community’ programs. He suggested that “involving schools, workplaces, places of worship, the mass media or local businesses could help mobilize untapped sources of social and spiritual care and support as well as practical resources”. Pallium has now brought this concept to Canada, launching its initiative in the fall of 2015.

Here in BC the BC Centre for Palliative Care has also endorsed the Compassionate Communities approach, noting that it can provide “access to the many social aspects of care that are not provided by the health care system . . . but which are central to the well-being of patients with advanced illness and their family / friend caregivers”.

But it seems to me compassion is something we need more generally in society, not just in dealing with death, but in living life. So I am heartened by the wider mandate assumed by one of the Compassionate Communities pilot sites, Windsor-Essex in Ontario. There the aim is “to increase the happiness and connectedness of everyone in the community, raise quality of life for citizens with life-long care needs, and to reduce the inequitable outcomes experienced by the most vulnerable”.

Their approach includes creating neighbourhood networks through social media to enable people to “to watch out and care for one another”; a ‘Distress Outreach’ system, operated through the Distress Centre that “aims to ensure that those who need help do not fall through the cracks”, and creating a ‘Citizens’ Care Hub’.

The Hub is intended for “people in their last year of life, with dementia, or who need personal support such as help with eating, dressing and bathing – that is, people who need a high degree of social and practical help as well as medical care to live well”. The people and their caregivers are then linked to a community volunteer, who helps them set up their volunteer personal care team.

Interestingly, the Windsor-Essex project is also involving young people by using “tech savvy students . . . to help out with technical support”. This fits well with another aspect of the Compassionate Communities approach promoted by Pallium; the Compassionate School, which is “a place of learning that incorporates death education into its curriculum”. I see this as an important step in re-introducing the reality of death and dying into our lives, and making our communities more compassionate.

© Trevor Hancock, 2017

 

 

 

 

Toward a BC Framework for Wellbeing

Dr. Trevor Hancock

13 March 2017

701 words

Too many governments seem to think that the business of government is business. This comes from the erroneous belief that the central purpose of government and society is economic development. And it leads to the equally erroneous belief that the corporate sector is governments’s primary partner. Of course, if they are the principal funders of your party, that may explain why you think that way – and that may lead you to go easy on them.

But there is a better approach, in which the central purpose of government is human development rather than economic development. In that case, organisations of people – as communities, as NGOs, as unions, as faith communities and so on – are the most important partners. Corporations are partners only to the extent that they are contributing to human development.

But to the extent that their activities damage human health or social wellbeing – be it here in BC or elsewhere in the world – corporations are not fit to be partners of a government committed to human development. On the contrary, they would be subject to regulation and taxation intended to prevent the harm that they might otherwise cause.

Moreover, if our purpose is human development, a simplistic focus on job creation – any kind of jobs – is wrong-headed. We need jobs that contribute to, not take us away from, the overall goal. There are lots of jobs in selling tobacco, or in making and selling junk food or in polluting industries – and many more jobs in treating the health consequences of these bad practices. These all add to the GDP, which only shows what a truly idiotic measuring stick it is. But that is not a healthy way to do business or run a province or a country.

There is another aspect to the approach I advocate here that is worth noting, and that is how we consider human services. In a business-focused world, education, health care and social services are too often seen as expenses that must be reduced. But in a human-centred approach, these are investments we should welcome. In addition, we should recognise that the assistance and support that families provide for each other and that communities offer each other as volunteers are an important contribution to social wellbeing – a contribution that conventional economic accounting, such as the GDP, completely misses.

Which brings me to the BC Framework for Wellbeing that BC’s Board Voice is proposing. Board Voice is a non-profit organization that was established in 2010 to bring together and represent the volunteer Boards of BC’s social services sector. The organisation’s vision is of “strong, vibrant communities and a high-quality community social benefit sector”. Yet they point out that while BC spends billions of dollars annually on social interventions and supports “we spend it with no clear idea as to what we’re trying to achieve, or how we’ll know when we get there”.

Some of the problems they identify include Government ministries providing services and funding in vertical envelopes with little or no coordination; ad hoc and short-lived initiatives with few measured outcomes, and very little capacity at the local level to support community social planning. As a result, they state, “decisions related to community services are very often made by individual ministries and /or health authorities based on short-term fiscal plans, without significant input or consultation from and across communities”.

In short, we lack a comprehensive human development strategy, there is nothing to match the economic development strategies that governments spend so much time and energy on. So Board Voice is proposing the development of a social policy framework through a new project they are launching – There is a Better Way: A BC Framework for Wellbeing.

They are undertaking consultations in 15 communities around BC to learn how such a framework could benefit people and their communities, as well as consultations with key provincial organizations. Hopefully, the next BC government, whomever it is, will pay more attention to this issue, and will pay heed to the advice that will come from this process. We would all be better off if governments spent more time focused on human development and social wellbeing, and not simply pursuing the false god of GDP.

© Trevor Hancock, 2017