Praise for
All Together Healthy
A Canadian Wellness Revolution
Well researched, clear and convincing. All Together Healthy makes a strong case for improving our healthcare system by outlining the social factors that comprise wellbeing. The more we think together the healthier well besings the wellness revolution.Raffi Cavoukian, singer, author, founder of Child HonouringAll Together Healthy makes the compelling case that poor health is caused by societal factors such as income inequality and lack of investment in early childhood. MacLeod combines story-telling and evidence in a passionate and timely call for all of us to rethink our conception of and approach to health and to participate in building the much healthier society we could be.Monika Dutt, M.D., Executive Director of Upstream and past chair of Canadian Doctors for MedicareAndrew MacLeod has created a masterpiece that reflects universal influences on human health, illustrating how our health is impacted by broad social patterns, especially social marginalization. This inspiring book is a compelling argument against empty, self-interested rhetoric, and for enacting real, comprehensive and intelligently informed kindness towards all citizens, in order to lift up society as a whole.Warren Bell, family physician and past founding president of the Canadian Association of Physicians for the Environment
All Together Healthy
A Canadian Wellness Revolution
Andrew MacLeod
Copyright 2018 Andrew MacLeod
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system or transmitted, in any form or by any means, without prior permission of the publisher or, in the case of photocopying or other reprographic copying, a licence from Access Copyright, .
Douglas and McIntyre (2013) Ltd.
P.O. Box 219, Madeira Park, BC , V 0 N 2 H 0
www.douglas-mcintyre.com
Edited by Pam Robertson
Indexed by Nicola Goshulak
Cover design by Setareh Ashrafologhalai
Text design by Shed Simas / Ona Design
Printed and bound in Canada
Douglas and McIntyre (2013) Ltd. acknowledges the support of the Canada Council for the Arts, which last year invested $ 153 million to bring the arts to Canadians throughout the country. We also gratefully acknowledge financial support from the Government of Canada and from the Province of British Columbia through the BC Arts Council and the Book Publishing Tax Credit.
Library and Archives Canada Cataloguing in Publication
MacLeod, Andrew, 1972-, author
All together healthy : a Canadian wellness revolution / Andrew MacLeod.
Includes bibliographical references and index.
Issued in print and electronic formats.
ISBN 978-1-77162-188-5 (softcover).-- ISBN 978-1-77162-189-2 ( HTML )
1. Health--Social aspects--Canada. 2. Medical policy--Canada.
I. Title.
RA 395. C 3 M 29 2018 306.4610971 C 2018-900875-X
C 2018-900876-8
To my parents
Historians tell us that we have had two great revolutions in the course of public health The third revolution, in which governments and citizens work together to address the determinants of health, will ensure that Candians are the healthiest we can be.Roy Romanow, foreword to A Healthy SocietyIt seemed to me thenit sometimes seems to me now, for that matterthat economic injustice will stop the moment we want it to stop, and no sooner, and if we genuinely want it to stop the method adopted hardly matters.George Orwell, The Road to Wigan Pier
Contents
Introduction9
- Chronic Illness13
Little Care for a Known Problem
- Diagnosis33
Health Care and Canadian Pride
- Bad Habits45
Wasteful Spending and Ignored Needs
- Causes of the Causes63
Living Conditions, Wealth and Status
- Worrying Symptoms79
Mental Health Care and Tent Cities
- Self-Medicating95
The Overdose Crisis and Untreated Trauma
- Healing Traditions112
Trauma, Land and Indigenous Health
- Environmental Risk134
Climate Change, Pollution and Togetherness
- Healthy Beginnings145
Childhood and Future Hopes
- Treatment164
Supporting Incomes and Broad Approaches
- Prevention176
Persistent Blockages and Sunny Ways
- Better188
Acting Together for Healthy Generations
Endnotes195
Acknowledgments219
Select Bibliography221
Index231
About the Author240
Introduction
When I was a child, my father ran a laboratory at the Hospital for Sick Children in downtown Toronto. One day when I was about twelve, a friend and I were left to explore the lab while we waited for my dad to finish some work. With a piece of rubber tube, we hooked a glass filtering flask up to the labs vacuum system. I put the wide, open mouth of the bottle against my cheek. It formed a tight seal, pulling a circle of flesh into the bottle as the vacuum intensified. It began to hurt. A lot. There was some fumbling with the lever that controlled the vacuum, and we may have turned the pressure up instead of off. I tugged hard on the flask and it came off my cheek with a loud pop. Soon a dark, perfectly circular bruise rose on my face. What I demonstrated, I joked at my dads retirement dinner many years later, is that while curiosity may be genetic, clearly intelligence is not.
My mother also worked in health care. A physiotherapist, for many years she worked on a palliative care unit helping as people approached death. At her own retirement party, she advocated that it was time to blow up the system and let the healers emerge. The remark was met with uncomfortable titters from some of the colleagues she was leaving, but what she was getting at is that in health care there are many services that are provided because they always have been. People with entrenched interests were at times more interested in protecting their turf than they were in allowing innovation. While people would always need care, there are many ways to provide it.
My dad was remarried many years ago to a woman who has a PhD in pharmacology and who organized clinical trials for a drug company. In both homes, medical topics predominated and for a while I thought I might follow into the field. From when I was little, working in medicine had seemed a good idea. The family car had a licence plate that started MDD , which my dad said would be a signal to police if thered been an accident that he could help. Before reaching school age I often dug into my fathers black medical bag and played with the otoscope for looking in ears, his stethoscope and the reflex hammer. With the tools spread out on the carpet before me, there seemed no better calling than to have the skills to help when people are sick or injured.
Somewhere along the way my plans shifted. I entered university describing myself as a pre-med student, took science courses, but found the memorization in chemistry and biology classes a chore. I was more interested in participating on the school newspaper, where the stated and overly self-serious ambition to be agents of social change appealed. I took a year out of studying to co-edit the paper and when I went back to the classroom it was to take courses in English, history, philosophy and other arts. After graduating I found work as a reporter and over two decades Ive written frequently about health, poverty, social issues and the environment. While writing thousands of stories Ive had a chance to see up close the role public policy could play in improving the health of many people. Journalism has turned out to be a way to stay near the family business without having to mind the shop, as the saying goes.
