Kwame McKenzie is the CEO of the Wellesley Institute, a Toronto-based non-profit research and policy institute that focuses on advancing population health. Also a CAMH psychiatrist, he’s a leading expert on the social causes of mental illness and making our health system more equitable. Imagine a City spoke with Kwame for our ‘Ask the Expert’ series to learn how health and poverty are related.
1. Is there a connection between income and our health?
There’s a strong link between income and health. But, it’s not just about the amount of money you make and what you can buy, it’s what your whole life is like as a result, including where you live, work and the food that you eat. These factors—the social determinants of health—influence the health of individuals and even entire populations, putting vulnerable people at a higher risk of having poor physical and mental health and decreasing their life expectancy.
2. What are some examples of the social determinants of health?
On top of income, other factors that greatly affect our quality of life include gender, disability and race. Health is also determined by our ability to access quality education, nutritious food, adequate housing and social and health services. Another big factor is job security and working conditions.
3. How does poverty influence a person’s physical and mental health?
Living in poverty greatly impacts a person’s physical and mental health. For example, living on a low income means you’re going to be living in less adequate housing where air pollutants or mould could cause asthma. What we eat is a major indicator of our health status as well, and for many people living in poverty, accessing good, nutritious food is financially and physically not feasible. This could lead to very serious conditions such as high blood pressure, diabetes and heart disease. Precarious work is another major factor that brings with it a host of health concerns. Workers without job security often lack holidays, benefits or sick days and spend long hours commuting to work. This causes high levels of stress and anxiety as a result.
Unfortunately, all of these factors produce a vicious cycle, which both psychologically and physically makes a person more vulnerable to illness, even down to something like the flu. Once you’ve got one illness, you’re more likely to get another.
4. What are some of the best ways to address these issues to improve the well-being of Canadians?
Studies show that the healthiest people are in economies where they’ve decreased poverty, the gap between rich and poor and started really investing in people. That means ensuring access to good jobs, increasing food security and giving kids the best start in life. This last piece is especially important. Studies show a child’s resilience to both physical and mental problems is linked to the amount of face-to-face time with their parents. You can imagine how poverty has a generational impact. It produces a trajectory, which means increased risk of illness through childhood into adult life. That’s why the early years are so important. We have to make sure that children get proper nutrition and have access to child development programs and high-quality daycare to ensure kids get a good start in life.
United Way has a big hand in addressing these issues. They glue society together and make sure that people living in poverty or who are marginalized don’t fall between the cracks. It’s not glamorous, but it’s the biggest improvement we’re going to get in-house. Without United Way, all of the problems that we have with the social determinants of health and poverty would be magnified significantly.
5. Why is this an issue that affects all of us?
Healthy people can mean healthy communities, but healthy communities also breed healthy people. It’s a two-way street. Income inequality is important, because without a healthy economy and a healthy society, then people will not thrive. Ultimately, we need to focus on creating a society that’s inclusive and supportive of everyone in our community.