Treating poverty works like medicine, doctors say

Adding to poor patients' incomes works to decrease the health effects of poverty, Canadian doctors are finding.

The Canadian Medical Association is asking people across the country how poverty affects their health as part of its national dialogue tour. The group said that social and economic factors determine 50 per cent of health outcomes.

At his inner city family practice atToronto's St. Michael's Hospital, Dr. Gary Bloch puts income information at the top of the medical history he puts on his charts.

"Treating people atlow income with a higher income will have at least as big an impact on their health as any other drugs thatI couldprescribethem," Bloch said.

To that end, Bloch asks all patients what their income is and where they get it, along with the standard questions about past medical history, surgeries and medications.

"I do see poverty as a disease," Bloch said.

In his practice, prescribing income could mean assessing whether a patient's illnesses mightqualify for provincial or federal disability supports andemployment insurance.He helps fill inapplicationsandconnectspatients with programs such as basic financial planning.

"I absolutely see the improvement in my patients' health," Bloch said. "For patients that we do manage to get on income supports, their lives often really turn around."

Increasingly, physician groups are recognizing poverty as a disease, not simply from lifestyle factors such as smoking, but also from the toll thestress of being poor can take on the body.

Children bear 'toxic stress'

For children in particular, the strong and frequent bombardment of "toxic stress" from living in substandard housing with adults who are also stressed can set the stage for lifelong damage, doctors say.

Such high stressstunts healthy developmentby "disrupting developing brain architecture," the American Academy of Pediatrics said in a technical report last year.

"Toxic stress can lead to potentially permanent changes in learning, behaviour and physiology," the U.S. group concluded.

Statistics Canada has reported that growing up in poverty is associated with increased rates of death and illness including diabetes, mental illness, stroke, cardiovascular disease, gastrointestinal disease, central nervous system disease and injuries.

"We do know that ourchild poverty ratesare an embarrassment,"Dr. Richard Stanwick, president of the Canadian Pediatric Society, said from Victoria. "Do wewant a society where a certain group ispermanently disadvantaged? Unfortunately, that'swhat poverty does."

If children live in a neighbourhood that is considered unsafe, then parents may feel more comfortable keeping them indoors watching TV rather than playing outside, said Stanwich, who worksat the Vancouver Island Health Authority."That alone is contributing to obesity, is not contributing to the brain development and is probably putting these individuals at a disadvantage."

A nutritious diet and access to opportunities for recreation could do more for health care than building more hospitals, Stanwich said.

The CMA's dialogue on poverty wraps up in St. John's next month.