The North End Community Health Centre works to transform an oft-neglected part of the city
Healthy people, healthy democracy?By Suzanne Rent | Nov 7, 2012
Dr. Ryan Meili was on a bus in the Philippines when he got an idea for a book.
There, the Saskatoon-based physician treated his share of ill people, many of whom were displaced by a typhoon that hit the area. The lack of basic necessities and poor health was a scene Meili has seen before in rural communities in Saskatchewan and Mozambique, where he practiced medicine.
“They were showing up with totally preventable illnesses,” says Meili of his patients in the Philippine village. “I was once again frustrated by the stories of the people in front of me who were suffering as a result of bigger picture forces…everything I do as a doctor is nice and useful for the moment, but then people go back to their real lives and get sick again. We are really only dealing with the downstream. We are dealing with the symptoms and not the causes.”
Meili explores those symptoms and causes in his newly released book, A Healthy Society: How a Focus on Health Can Revive Canadian Democracy. He’s in Halifax tonight as part of his book tour.
The symptoms, he says, are lack of fundamental necessities such as housing, income, food and education, while the solution is politics. The book includes a number of stories from clinics he’s worked in to illustrate the connection between health and politics. Meili says when he talks about his ideas and his book, the connection between health and politics is one people understand, but not often see how it can be put into practice.
“It’s not really a hard sell,” he says. “You have to explain it and talk to the facts. We looked into this and know. Healthcare isn’t what keeps us healthy. It’s 10th on the list. It’s those other social aspects that make the difference. When you tell people that, mostly what I see is heads nodding, because I am telling them something so obvious,” he says. “Then it’s easy to get into the discussions around what the political choices would be.”
Meili himself could put his ideas into action, at least in Saskatchewan. He ran for the provincial NDP leadership in 2009 and announced he’d run again next year. The solution, he says, is not hiring more doctors and nurses, but rather dealing with those issues, such as employment and housing, that directly affect health outcomes. And parties need to put aside ideology to work together.
“We bounce around from crisis to crisis, from scandal to scandal,” Meili says. “We see political decisions based on polling and ideology rather than on good sense. Good sense to me is using the evidence, like in medicine, moving from doing what we think might work to listening to the studies and evidence-based medicine. We need to make the same transition in politics to evidence-based policy.”
Some countries, he says, already get it right. He points out that in Sweden every minister is considered a “health minister” because whatever their portfolio, economics or environment, has an affect on health.
Dr. Jane Moloney, who will be introducing Dr. Meili at tonight’s launch, understands his theory well. As the executive director of the North End Community Health Centre on Gottingen Street, she sees firsthand how a lack of housing, employment, income and opportunities results in poor health outcomes. She says the key is to address these inequities, break down barriers and empower people, which will benefit everyone.
“Do we really want to empower people or do we have a system that disempowers them?” she says. “Those who have more need to know it hurts them when others have less.”
As for the book launch tonight, Meili says he’s looking forward to talking about the realities in Halifax and how the bigger picture can change across the country.
“I really want to push the idea of health beyond healthcare and focus on what really makes us healthy, and look at how that can change how we do politics,” he says. “We need a good healthcare system, but we also need to recognize that our goal is not to get sick and go somewhere. Our goal is to be healthy.”
The Halifax book launch of Dr. Meili’s A Healthy Society: How a Focus on Health Can Revive Canadian Democracy takes place at 6:30 p.m. at The Company House, 2202 Gottingen Street.