Children and Youth in Mental Health Crisis

On October 19, 2021, the American Association of Pediatrics declared a national emergency in children’s mental health. They cited soaring rates of depression, anxiety, trauma and loneliness in American children and youth as reasons for this unprecedented declaration.

The picture is no less grim in Canada. Even before the pandemic, poor mental health was ranked second among threats to childhood in Canada. And suicide is the leading cause of death for children aged 10 to 14 in Canada and the second leading cause of death for youth aged 15 to 24.

Researchers in Ontario found that 70% of school-aged children and 66% of preschool-aged children experienced a deterioration in at least one of six domains of mental health – depression, anxiety, irritability, attention span, hyperactivity, and obsessions/compulsions – during the first wave of the pandemic.  Effects were not equal among all children and youth. Mental health deterioration was worse in those with preexisting mental and physical health problems, autism spectrum disorder and those living in adverse socio-economic circumstances and in racialized communities. Higher rates of social isolation were also associated with worse mental health outcomes.

Schools provide a safe, predictable and structured space for children and youth with opportunities for regular contact with peers and teachers. School closures and public health restrictions took this away. Studies show that symptoms of depression and anxiety in children aged 6 to 18 increased in proportion to time spent in online learning.

Mental health problems can negatively affect learning resulting in lower school engagement, lower academic achievement, and higher school drop-out. Research shows that reading scores worsened during the pandemic especially in younger children. A Dutch study starkly revealed that “students made little or no progress while learning from home.” This effect is particularly true for students from disadvantaged backgrounds.   

Academic achievement aside, children missed out on school sports and other extracurricular activities known to boost physical and mental health. They also missed out on other key health services provided through schools such as nutrition programs, counseling sessions, specialized learning supports, and vaccination programs. 

“We can all play a role in supporting children and youth whether or not we work with them.”

Children and youth are embedded in their families so it is not surprising that children from lower household incomes and lower parental education rates suffered from higher rates of mental health symptoms due to family stresses like parental job loss and food insecurity. Children whose parents were suffering mental health problems were impacted by their parents’ difficulties and vice versa. 

Children who suffer from mental health problems early in life are more likely to have future problems with education, family and social functioning. We need to prioritize their mental health now so that we have a healthy, well-functioning adult generation in years to come.

Educational and health professionals who work with children and youth need to take a family-centered approach. Children in crisis are often holding up a mirror to a family in crisis. Recognizing the root cause of a child’s problems – which may be parental job loss, depression or substance abuse – and supporting families to face this challenge will be more effective than a narrow focus on labeling children with psychiatric conditions and prescribing medication.

We can all play a role in supporting children and youth whether or not we work with them. A positive relationship with a trusted adult is a strong protective factor for adolescents and youth. Even adults who have short but regular, positive interactions with youth who are struggling can make the difference between crisis and resilience.

But it takes more than a village to raise a child. We need cooperation and collaboration at all levels of government – municipal, provincial, federal and Indigenous – to ensure that child and youth mental health and wellness are prioritized and supported.

A national strategy rolled out by the federal government with dedicated mental health funding will be key to reducing disparity in policy and practice across our country. Suicide prevention needs to be integral to the strategy particularly to improve the lives of First Nations, Métis and Inuit youth and adolescent boys who are disproportionately affected.

Provinces need to ensure that continuous and timely access to culturally safe and appropriate mental health services are available to children and youth during all phases of this and future pandemics. School-based programs are key to reaching all children no matter what their background. 

Knowing what we know about the adverse effects of school closures, provinces need to keep schools open safely during pandemics and other emergencies both for academic programs and for extracurricular sports and activities so vital for students’ mental and physical health. 

All levels of government have to support access to adequate social determinants of health – sufficient income, decent housing, healthy food and freedom from racism and discrimination – to make sure that our children thrive during and beyond the pandemic.
Mental health priorities need to be embedded into pandemic and emergency preparedness plans from the beginning, because there is no health without mental health.

By Vamini Selvanandan© 2021. This work is licensed under a Creative Commons CC BY 4.0 license. This article was originally published in the Rocky Mountain Outlook on Nov 18, 2021. Photo by Skitterphoto on Pexels.com

Further Reading 

American Academy of Pediatrics. AAP, AACAP, CHA Declare National Emergency in Child Mental Health

Children’s Mental Health Ontario. How the Pandemic Impacts Children’s Mental Health

UNICEF. Impact of COVID-19 on poor mental health in children and young people ‘tip of the iceberg

Help wanted in the hospitality industry

There is a scarcity of hospitality workers in Alberta and across Canada. According to Statistics Canada, the number of unfilled hospitality jobs in Canada have almost doubled since before the pandemic. How can we reconcile the labour shortage lamented by the hospitality sector with high unemployment rates across the country?

A recent study by the Canadian Centre for Policy Alternatives (CCPA) might have the answer. Their economic analysis shows that low wage jobs, such as those in the hospitality sector, have higher job vacancy rates and this effect has become more pronounced with the pandemic.

Finding themselves furloughed during the first, second and third waves of the pandemic, hospitality workers had time to take stock of their careers. Many decided that the low pay rate, long and unpredictable work hours, and lack of sick days and holiday pay were simply not worthwhile and have opted for a career change.

According to the CCPA study many have taken jobs in the professional, scientific and technical services sector. They have retrained, started businesses or focused on work that they previously did not have time to do.

Former hospitality workers are speaking out. Many service workers are women and racialized minorities. They endure sexism, racism and sexual harassment as common occurrences in their work day. 

In the United States, the restaurant industry has the highest rate of sexual harassment at five times all other industries. Paying workers less than a fair wage and expecting tipping by customers to top up earnings further entrenches sexualized and racialized exploitation in the industry. 

While many view tipping as a way of encouraging good service and hospitality, it forces a complex power play between workers, employers and customers. Workers have to tolerate mistreatment by customers to make sure they receive a tip to top up their below minimum wage, and employers can reward or punish employees by deciding which shifts they work and consequently how much tip they make.

Nearly half of service workers recently surveyed report symptoms of stress and burnout. Burnout leads to employee turnover and feeds the vicious cycle of worsening work conditions for the remaining workers. Service workers are also having to endure verbal abuse and threats from hostile customers when enforcing public health rules around masking and proof of vaccination. 

“If businesses in the hospitality industry want to survive and thrive after the pandemic, they will have to closely examine their business model.”

Some employers are shining examples of best practices in the industry. We are hearing from some small and medium-size restaurant owners that nearly all their staff came back to work for them after the furloughs forced by the waves of the pandemic. And they did so happily.

There are striking similarities in what these employers say about why. They talk about how much they valued their employees before the pandemic. They talk about having provided them with a living wage, extended benefits and predictable hours. These business owners now have a full workforce and a competitive advantage because they cared about supporting their employees before and during the pandemic.

If businesses in the hospitality industry want to survive and thrive after the pandemic, they will have to closely examine their business model. Businesses dependent on paying rock-bottom wages to undervalued employees and exploiting them for their physical and emotional labour may find that they are no longer viable.

Increasing wages, and passing on the expense to customers, is one option to improve the labour shortage and attract workers back to the industry. Another option is for individual businesses to cut back on hours and capacity so as not to burnout the staff that are currently willing to work in the business.

The provincial government can go a long way in helping out the hospitality industry by increasing minimum wage for service workers and eliminating the need for reliance on tips. This levels the playing field for all businesses and makes higher prices more acceptable to consumers. 

Businesses will still have to take into account that living wages vary across communities and some towns like Canmore have a living wage close to $31/hour for families of two working parents with two children.

No doubt many businesses will be looking to import foreign workers as an answer to their labour shortages. If there is no change to the pay, benefits or difficult work conditions in the industry this simply amounts to exchanging exploitation of Canadian workers for the exploitation of foreign workers. 

It is not sustainable or acceptable for an industry, or indeed a country, to build its economy on the planned and systematic mistreatment of immigrants. The Canadian government will have to provide foreign workers with protection of their labour rights, humane and family-centered immigration policies and a pathway to citizenship if they expect them to move to Canada to do work that Canadians, despite high unemployment rates, refuse to do.

If as a society, we don’t serve the needs of our workers, we may very well find that we will to have to serve ourselves the next time we dine out.

By Vamini Selvanandan© 2021. This work is licensed under a Creative Commons CC BY 4.0 license. This article was originally published in the Rocky Mountain Outlook on Oct 21, 2021. Photo credit by cottonbro on Pexels.com.

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Everyone deserves to share in the bounty of our land

As harvest time approaches, many of us look forward to sharing food-laden tables with close friends and family. It is a time of plenty and conviviality.

Sadly, this will not be the case for 13% of Canadians who are food insecure – those of us who do not have access to food of sufficient quantity and quality due to financial constraints.  

Food insecurity exists in a spectrum, from anxiety about not being able to access enough food to eating food of decreased quality to food deprivation. In 2012, 4 million Canadians were food insecure – the highest level since we started measuring food security in Canada.  

The health effects of food security are wide-ranging.  Children may experience short stature, anemia, asthma or even depression or suicidal ideation from lack of access to sufficient nutritious food.  Adults experience a host of physical and mental health problems including heart disease, diabetes, hypertension and depression.  

Even infants suffer from food insecurity because mothers who are nutritionally deprived stop breastfeeding sooner and are forced to switch formula brands constantly based on availability from food banks, sometimes consuming expired bottles of formula due to poor supply.

The relationship between food insecurity and health goes in both directions. Poor food access gives rise to poor health and those who have poor health or chronic disease have less money to pay for food due to decreased ability to earn an income and increased expenses for medications and rehabilitation services.

In adopting the Universal Declaration of Human Rights in 1948, Canada recognized the right to food as an inviolable human right. In 1989, the House of Commons passed a resolution committing the government to the elimination of child poverty by the year 2000. 

“Canada’s main response to food insecurity has been to treat it as a charitable issue rather than a social injustice.”

Yet in 2021, far too many children go hungry in Canada. This is a shocking and shameful state of affairs in a country where economic growth has continued to increase unabated in this same time period and the top 1% of wealthy Canadians have continued to accrue wealth at increasing rates.

Why do we see this paradox of increasing wealth and prosperity on one hand, and deepening hunger and poverty on the other? 

In Canada, as in many other high-income countries, we have adequate resources to support decent living conditions for our entire population but we have a problem with unequal distribution of those resources.

Canada’s main response to food insecurity has been to treat it as a charitable issue rather than a social injustice. 

Prime Minister Trudeau summed up this response succinctly at Thanksgiving last year when he urged Canadians to “consider grabbing an extra item or two for the local food bank” while at the grocery store because “it’s the Canadian way”. 

Food insecurity is not a food problem but money problem. And people who are food insecure are not to be pitied and deemed deserving of our charity, but to be recognized as members of our society who are disadvantaged as a result of prevailing social and economic policies. 

Food insecurity needs to be addressed at its root cause – income inequality.  Policies to improve food security are policies that guarantee an income that individuals and families can live on in a healthy, safe and dignified manner. 

There is no better proof that this works than when we look at the introduction of a guaranteed minimum income for seniors. When the Old Age Benefit was paired with the Guaranteed Income Supplement, rates of food security in seniors plummeted from 28% to 5%.

Raising the minimum wage to make it a living wage, increasing worker’s compensation and social assistance payments to cover the essentials of life and providing a basic guaranteed annual income for all Canadians are policies that are certain to reduce food insecurity.  

Policies to create increased employment opportunities and provide robust universal programs for childcare, pharmacare and affordable housing will also increase the ability of Canadians to spend more on nutritious food.

It should be not the Canadian way to take away people’s dignity so that they are forced to rely on food banks. It should not be the Canadian way to keep people in poverty so that others can feel good by doing charity. The Canadian way is to respect our fellow citizens’ dignity and give everyone an opportunity to share in the bounty of our land.

By Vamini Selvanandan© 2021. This work is licensed under a Creative Commons CC BY 4.0 license. This article was originally published in the Rocky Mountain Outlook on September 16, 2021. Photo credit: Engin Akyurt from Pexels.

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Human values unite us

We hear much about polarization in society these days, and with upcoming federal and municipal elections, the rhetoric around what divides us will become heightened. But the truth is that when it comes down to it, Canadians and Albertans have much more in common with each other than politicians and the media will have us believe.

We want to live a healthy, happy and comfortable life. We want fresh air and clean water and a healthy planet that will nurture and sustain us. We want a bright future for our children.

It is hard to argue with these values because they are universal human values. And right now this is very apparent in every community in Alberta. Seeing these values threatened, Albertans are speaking up to defend them. 

The lawn signs say it all. Protect Our Water. Defend Alberta Parks. Protect Education in Alberta. Don’t pull the plug on public health care.

Behind the lawn signs are very concerned Albertans who realize that the people who promised to preserve what’s most important to Albertans have forgotten this now that they are in political office. 

“We need to educate ourselves on the roles of the three main levels of governments, their responsibilities and how they operate.”

Dedicated and engaged citizens are committing to protecting our values, our land and our collective well-being. Faced with a common threat, we are reaching out to other Albertans with similar concerns. But advocating for what we believe in can be difficult and time-consuming. Using strategies to maximize impact will be crucial. 

We can connect with like-minded people who care and want to make change. Collectively we can make our voices louder and make the work lighter by building coalitionsWhen people and organizations join together and promote a common cause, our voices become amplified and much harder to ignore.  

We need to look for windows of opportunity that open up for a specific issue. Even if we are advocating for our cause all the time, we need to be prepared to leap at a window of opportunity that presents itself. For example, the COVID-19 pandemic presented an opportune time to ask for improved conditions in Canada’s senior care homes. The tragic death of George Floyd provided an opening to demand action to address structural racism within the police force.

We need to educate ourselves on the roles of the three main levels of governments, their responsibilities and how they operate. This allows us to focus our advocacy on the right audience and tailor our requests to the powers invested in the policymakers we are addressing. For example, changes to senior care homes will need to come from provincial and federal policymakers rather than municipal politicians.

We can identify a policymaker at the suitable level of government who is willing to sponsor our policy request. If we want our town to fluoridate drinking water to prevent tooth decay in children, we can meet with individual town councillors and educate them on the benefits to children’s health from this intervention. It will become quite clear if one or more councillors are sympathetic to the issue and if they will be willing to turn our request to fluoridate drinking water into a motion at a council meeting. Making our request specific to legislation, regulation, programming or funding will align with how councils operate.

Finally, we don’t have to take no for an answer. If we are met with disinterest or opposition, we can reframe our request – if town councillors won’t fluoridate drinking water, then we can ask them to support children’s dental health in other ways by providing funding, services or regulation that ensures that all children can develop healthy teeth. 

And, we can keep making our request at different times and in different ways. The political cycle is four years but our time horizon is much longer. When in the election cycle we make our request can make a difference to the answers we get. A politician vying for election or re-election has different motivations from one who has just been elected.

Let us remember that we all share the same core human values and that there is more that unites us than divides us. When we act as engaged citizens, we are ordinary people who do ordinary things that make an extraordinary impact.

By Vamini Selvanandan© 2021. This work is licensed under a Creative Commons CC BY 4.0 license. This article was originally published in the Rocky Mountain Outlook on August 19, 2021. Photo by Artem Podrez on Pexels.com

Recommended further reading:

Prosperity Now. How Do I Advocate for Policy Change?

Courtney Harris Coaching. 20 Ways to Be An Advocate for Social Change and Transformation

American Dental Association. 5 Reasons Why Fluoride in Water is Good for Communities

Climate change is a health crisis

As we cope with extreme heat waves and unpredictable wildfires this summer, it is hard to deny that climate change is a reality. With record setting high temperatures in many places in the West, this stretch of hot weather is a searing reminder of how human actions are affecting our planet. If global warming continues unabated, it is easy to imagine how life will become unbearable.

The health of humans and the health of our planet are inextricably linked.  The effects of climate change on human health are already evident in Canada and so many other places in the world. Our northern latitude exaggerates the effect of climate change and disproportionately affects populations living in the Far North including many Inuit communities whose livelihoods are intertwined with the conditions of the land. 

Climate change is the biggest public health threat of the 21st century. The World Health Organization estimates that 5 million deaths will occur due to heat, malnutrition and diarrheal diseases attributable to climate change between 2030 and 2050. The scale and severity of the impact of global warming on human health can put health systems, economies and even global security at risk.

Climate change has both direct and indirect impacts on health. Heat waves, hurricanes and wildfires result in heat-related illness, trauma and death. Warmer temperatures increase the range of insect-borne diseases such as Lyme disease, malaria and West-Nile virus resulting in their spread to parts of the world they were not found in before.  Climate change also has significant effects on mental health as extreme weather events can increase anxiety, post-traumatic stress disorder and suicide risk. 

Labour productivity is reduced during natural disasters and heat waves and these economic losses can lead to poverty and widening of inequality in society. Globally, climate change causes food insecurity, migration of populations and conflict between groups competing for the same resources such as water and fertile land. 

Fortunately, we have the technical and policy knowledge to avert climate disaster. What we need to do is create political will for immediate action and push our decision-makers to make use of the tools we have to keep us, and our planet, healthy. 

Any attempt to modernize Alberta’s coal policy should have the phase out of coal as its focus.

The federal government’s Strengthened Climate Plan to reduce greenhouse gas emissions falls well short of what is required to stay below the 1.5oC target outlined in the 2015 Paris Agreement. To achieve this critical goal, we need to decarbonize quickly with at least a 45% reduction in greenhouse gas emissions from 2010 levels by 2030 and net zero by 2050. Sadly, our greenhouse gas emissions are higher today than they were in 2010 and are not projected to reach even the modest target set by the federal government for 2030.

Carbon pricing is a vital policy tool that forces the fossil fuel sector to pay for environmental and health costs resulting from their profitmaking activities. It also helps level the playing field for the renewable energy sector whose newer technology is currently more costly to develop and put into operation. 

Fortunately, all major federal parties now support carbon pricing but the effectiveness of the policy depends on setting a high enough price on carbon to discourage fossil fuel use and on directly supporting renewable sources of energy. Setting minimum requirements for carbon-free sources of energy in the energy mix and increasing incentives for renewable sources of energy will accelerate a transition away from carbon.

Fossil fuel subsidies are on the decline but still overshadow incentives for renewable energy sources. Income from carbon pricing and a reduction in fossil fuel subsidies can be used to pay for a just transition for individuals and communities that currently rely on the fossil fuel sector for their livelihood. 

The Government of Alberta’s website proudly claims that “coal-fired plants currently generate most of Alberta’s electrical power.” Yet, electricity generated by coal results in more air pollution, mercury release and greenhouse gas emissions than any other source of electricity.

Any attempt to modernize Alberta’s coal policy should have the phase out of coal as its focus. The United Kingdom has shown the world that this can be done quickly and effectively. By dramatically reducing coal use from 40% in 2012 to less than 5% today, they reduced greenhouse gas emissions to the lowest levels seen since 1890. The United Kingdom is projected to be completely coal-free by 2024.

For decades, politicians have heard about the reality of climate change from scientists and about the threats of climate change to our natural world from environmentalists. Yet they have not acted. It is time they heard from us, the people that elect them. We don’t want our government to mount a weak and inadequate response to the biggest public health threat of the 21st century. We need to make our demands for policies to reduce global warming clear to our elected officials at all levels of government. Because healthy people need a healthy planet.

By Vamini Selvanandan© 2021. This work is licensed under a Creative Commons CC BY 4.0 license. This article was originally published in the Rocky Mountain Outlook on July 15, 2021. Photo credit: Anna Shvets on Pexels.com

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Transformative change needed in care for seniors

In the wake of horrors laid bare by the COVID-19 pandemic in our senior care facilities, the Government of Alberta commissioned a review of facility-based continuing care in the province.   Recommendations from the government-appointed panel were released at the end of last month.

The report makes several important recommendations on improving quality of life for residents, public reporting of audit results, keeping couples together and providing more choice in community-based continuing care services. It also addresses the importance of treating those working in care homes better by improving staffing levels, wages and work conditions.

These recommendations will be a huge improvement from the current state of affairs and Albertans should hold the government accountable for implementing these changes fully and expediently. For too long, seniors have endured unacceptable conditions that don’t meet basic human rights – the right to privacy, the right to nutritious food, and the right to live with their life partner. 

Where the report misses the mark is in calling for incremental rather than transformative change. What is needed is a fundamental cultural shift in how we envision and provide care for the elderly. 

We have to create living environments that support a meaningful life filled with purpose, dignity and opportunity to thrive for our seniors.  This should be the minimum set of expectations for senior care. It is not enough to provide care that avoids violations of human rights.

Senior homes today are based on medical models that over-emphasize safety and physical well-being to the detriment of mental, social and spiritual well-being. Health and safety are important considerations but we need to shift the focus to providing a home where seniors can continue to live purposefully and with dignity and autonomy. 

“Where residents are expected to be passive recipients of services, they lose their sense of purpose”

Dignity requires that seniors are not forced to share a room and a washroom with a stranger. Autonomy requires that seniors decide when they wake up, when they get dressed and when they eat. And most importantly, a meaningful life requires purpose and opportunity to make a contribution. 

Seniors need opportunities to care for themselves and others according to their physical and cognitive abilities. Where residents are expected to be passive recipients of services, they lose their sense of purpose and are unable to maintain their physical and cognitive abilities. 

Similarly, we need a cultural shift in how work is organized in continuing care facilities. In addition to good pay, work conditions and training, workers need more time to develop relationships with patients and autonomy to provide customized care. Given flexibility they can focus on relationship-building and meeting needs for social interaction.  Injecting joy and life into the residents’ days becomes the key objective instead of providing medical care to merely extend days of life.

The report also does not address the commercialization of seniors’ homes. For-profit businesses are obliged first and foremost to maximize profits for their shareholders and to turn a profit, they have to reduce what they spend on staff and residents. During the COVID-19 pandemic, we have seen this business model result in higher death rates in private long-term care facilities. These businesses cut corners by having lower staff levels and overcrowding of residents. Contracting out of cleaning, laundry and food services also created unnecessary portals of entry for the virus.

Primacy of profit margins makes the private operation of senior homes mathematically incompatible with quality care and decent work conditions.  This simple fact seems to have escaped MNP, the accounting firm commissioned by the government of Alberta to author the report.

The report also highlights the operational and capital cost savings that can be achieved by increasing home-based services for seniors. But aging in-place has benefits that go well beyond economic considerations. For most people, there is no place like home and home is where they want to live in their final years. 

With more home-based continuing care, we will need to be innovative in combatting the pandemic of loneliness that pre-dated the COVID-19 pandemic. Creating appealing indoor and outdoor community spaces; increasing intergenerational connectivity where children, working-aged adults and seniors interact regularly; and improving mobility for seniors through accessible public transportation and walkways will need to be key adjuncts to increasing home care supports in the community.

Care for seniors is far too important to be left in the hands of medical doctors and accountants. We all need to step up and call for a system that will allow our seniors (and our future selves) to thrive physically, mentally, socially and spiritually in the golden years.

By Vamini Selvanandan© 2021. This work is licensed under a Creative Commons CC BY 4.0 license. This article was originally published in the RMOToday.com on June 17, 2021. Photo credit:Andrea Piacquadio on Pexels.com

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Federal-provincial cooperation a must in childcare

Canada is the weakest investor in early learning and childcare among wealthy countries and, not surprisingly, we rate last in meeting early childhood development objectives. However, this state of affairs may be dramatically altered by the $30 billion dollar investment in high-quality childcare announced in the federal budget last month.

Early learning and childcare are key in determining the future of our children. Early childhood development directly affects children’s health and their health as adults. It charts the life course affecting education, employment, income, lifestyle and status in society. High-quality early learning opportunities can lift children out of poverty and make societies more equal. 

Studies on very low-income American infants attending early learning and childcare programs show that these children commit fewer juvenile crimes, complete high school at higher rates, and earn more as adults than those children not able to attend such programs.

Poor children benefit more but all children, regardless of class, benefit from early childhood education. Swedish children who attended publicly funded childcare centres have better performance in school and are better socially and emotionally adjusted than those who did not, irrespective of family income.  

Almost all European countries have publicly funded universal childcare systems.  But in Canada, we have a patchwork of private operators providing childcare from the for-profit, not for-profit and informal sectors. Only 17% of Canadian families have access to government regulated childcare space. Most children are cared for in unregulated spaces where their health and safety cannot be guaranteed and the quality, or even existence, of developmental programming is unknown.

Everyone, no matter their political stripe, can agree that investing in children is worthwhile for both their inherent value and for the prosperity of our country.

To benefit from early learning and childcare, children need to receive high-quality services.  They need to have an adequate number of trained adults supervising them in a well-designed physical environment.  They need to be challenged by enjoyable, play-based learning activities.  And those taking care of them need to have decent working conditions and wages commensurate with the importance of the work they do. Taken together, these conditions need public funding and oversight, because they are seldom met in for-profit or informal childcare settings.

While directly benefiting children, early learning and childcare programs also provide much needed support for parents.  They allow parents, especially mothers, to participate in education, training and employment. They also provide caregivers with parenting support, social support and referrals to community resources at a time when they are struggling to balance work and family. 

Childcare programs strengthen communities by bringing together children and families from different backgrounds and foster inclusion and respect for diversity. Social cohesion is enhanced as parents from all walks of life come together for a common goal. The broader community also benefits by decreased crime rates, fewer high school dropouts, and increased contributions to economic, cultural and social productivity.  

Everyone, no matter their political stripe, can agree that investing in children is worthwhile for both their inherent value and for the prosperity of our country. Yet, it has been over 50 years since the Royal Commission on the Status of Women first recommended a national childcare program. 

We must make sure that the current federal proposal will be successful in meeting the needs of children, families and communities.  We must demand cooperation between provincial and federal leaders to make sure that no child or family gets left behind. 

In Alberta, the UCP’s response to the federal announcement of national childcare funding has been less than enthusiastic. Premier Kenney has said that not-for-profit centres to be funded by the federal program will not serve the needs of some Albertan families including those who live in rural and Indigenous communities and those who stop working to care for their children.

We cannot leave this money on the table to the detriment of our families.  The federal funding will go a long way in creating childcare centres in rural areas and on Indigenous reserves where such services may not have been viable in the past. Low-cost childcare will allow children whose parents chose to stay at home to care for them to still take advantage of learning opportunities offered by childcare centres even on a part-time basis.

The UCP government says there isn’t enough choice for parents in the federally proposed program.  We must let our provincial leaders know that Albertan families want to have the choice of low-cost, high-quality early learning and childcare. According to the United Nations, quality early childhood education is not a choice, it is a human right.

By Vamini Selvanandan© 2021. This work is licensed under a Creative Commons CC BY 4.0 license. This article was originally published in the Rocky Mountain Outlook on May 20, 2021, 2021. Photo credit: Anna Shvets on Pexels.com

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Taxes are wise and necessary investments

This is the time of year we are all compelled to think about taxes. A few of us might get excited about the prospect of receiving a refund, but most of us dread this annual chore and would rather do without it. This time of year also presents us with an opportunity to reflect on what taxes are and what purpose they serve in society.

Taxes are essential investments in public resources. Without taxes we would not have hospitals and highways, schools and satellites, or power grids and ports. Through taxes, citizens pool resources to create public goods for the use and benefit of all. Everyday, we benefit from the investments our parents and grandparents made to create quality health care, effective public
education, dependable transportation and reliable communication. These public goods are such an integral part of our everyday life that they are almost invisible to us.

We need to maintain these public investments and grow them for future generations so they too may enjoy the benefits that we have come to take for granted. The way we can do this is, firstly, by supporting a fair and robust taxation system; and, secondly, by strengthening government which is the system we have devised to combine, create and manage public resources for the common good.

What does a fair and robust taxation system look like? Simply put, it should support the idea that those who take more from public resources should pay more into them. This would include large corporations and very wealthy families and individuals who are heavier users of publicly funded
transportation infrastructure, utility grids and a workforce educated by public funds, than small businesses or middle-class families and individuals.
Taxation also needs to be redistributive and work to create a level playing field to reduce inequality in society. We know that income inequality adversely affects both rich and poor with unequal societies having higher crime rates, and increased physical and mental illness.

Canada is the only G7 country without a wealth, inheritance or estate tax

Progressive taxation – taxing individuals and corporations making more income or profit at higher rates – not only ensures that they pay their fair share for use of public resources but also redistributes resources to those who need them by strengthening financial, social and physical
infrastructure.

While many small family businesses have struggled or closed during the COVID-19 pandemic, several of the largest corporations have performed very well. An excess profits tax on these corporations will ensure that governments collect much-needed revenue to pay for the costs of
the pandemic while preventing these entities from profiting disproportionately from the pandemic.

Another form of fair taxation is a wealth tax such as the one that exists in Norway. Canada is the only G7 country without a wealth, inheritance or estate tax, and we allow money to become concentrated into the hands of a few ultra-rich families. During the pandemic, Canada’s top billionaires have increased their wealth by 28% (or $50 billion). And over the past decade, only the top 1% of Canadians have increased their share of wealth. Fairness requires that if you get wealthy using public resources that others paid for, then you should pay a share of your wealth in taxes so others are repaid.

In Canada, the federal NDP proposed a one percent tax on those with a net wealth of more than $20 million. This modest proposal would raise more than $5 billion dollars in federal revenue and would go a long way towards paying for services of value to Canadians such as national pharmacare and universal access to childcare. National survey data shows that 79% of Canadians are in favour of the 1% wealth tax, with support being strong across all provinces.

A number of tax loopholes act as barriers to fair taxation at the federal level. They result in wealthier individuals and families paying taxes at lower tax rates than middle-class and lower income families.

For example, when you work for a salary, you pay taxes on every dollar you make, but when you sell an investment at a profit, capital gains tax only applies to half the gain and the other half goes untaxed. Treating profits from investments like wages would raise an additional $17 billion
in tax revenue to invest in public resources. This would also prevent speculation, particularly real-estate speculation, that is making housing unaffordable for many Canadians.

As engaged citizens, we need to advocate for a combination of fair taxation policies and effective, accountable and responsible governance. This will ensure that our investments will provide dividends now and for years to come.

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By Vamini Selvanandan© 2021. This work is licensed under a Creative Commons CC BY 4.0 license. This article was originally published in the Rocky Mountain Outlook on April 15, 2021. Photo credit: Nataliya Vaitkevich on Pexels.com

Recommended further reading:

COVID-19 vaccine policies explained

Following a worrisome wait for a renewed supply of COVID-19 vaccines, many Albertans now have the opportunity to receive their vaccine much sooner than expected.  Many are pleased at the accelerated timelines and are ready to roll up their sleeves, but some are anxious or confused about the evolving COVID-19 vaccine recommendations.

COVID-19 vaccine guidelines are receiving much more interest by media and the general public than vaccination recommendations usually do during non-pandemic times. While this is helpful in informing and educating the public, it can also create high levels of anxiety if communication is not complete or clear.

To date, Health Canada has approved four different COVID-19 vaccines for use. All are safe and effective, but each has a different efficacy reported in clinical trials conducted by the manufacturer.  How is the layperson to interpret this information?

The key is understanding that reported efficacies for the four vaccines cannot be compared directly. No head-to-head trials were done to enable this comparison.  Each manufacturer conducted trials using different definitions of COVID-19 disease, in different countries, at different times with different levels of variants in circulation and in populations with varying demographic characteristics (age, underlying diseases such as diabetes, hypertension or heart disease, etc.).

What we do know is that all four vaccines protect very well against hospitalization and death from COVID-19 infection.

The Pfizer BioNTech and Moderna vaccine trials were conducted earlier when fewer variants were in circulation while the Johnson & Johnson trial was conducted later and enrolled more people over the age of 60 and with comorbidities such as HIV, diabetes and hypertension. These differences can affect the reported efficacy and make it impossible to compare vaccines directly.

What we do know is that all four vaccines protect very well against hospitalization and death from COVID-19 infection and all vaccines surpass the standard set by the World Health Organization for preventing any disease including mild illness.

What we don’t know is whether the vaccines can protect against long-term symptoms after COVID-19 infection. Similarly, we do not know if any of the four vaccines reduce the risk of transmission to others or how long immunity from vaccination will last. 

Concerns have been expressed around the National Advisory Committee on Immunization (NACI) recommendations for extending the dosing interval to 4 months from the shorter timelines used in the trials for vaccines requiring 2 doses.

The committee analyzed real world data and found that there were sustained high-levels of protection at 2 months after the first dose for the Pfizer BioNTech and Moderna vaccines.  Noting that immunity wanes gradually and does not “fall off a cliff” at two months, and citing a clinical trial showing that delaying the second dose of the Oxford-AstraZeneca vaccine for 12 weeks or more provided better protection against symptomatic disease, NACI expresses confidence that it is safe and beneficial to extend the dosing interval to cover as many people as possible within the shortest time frame.

Eighty percent of the Canadian population over 16 years can receive one dose of a vaccine by June 2021 with the extended dosing interval.  This policy would minimize hospitalization and deaths which clearly comprise the worst outcomes for COVID-19 infection. Achieving immunity in a large proportion of the population will rapidly drive down numbers of COVID-19 cases and bring the end of the pandemic and a return to normal life within reach.

NACI is monitoring data being collected weekly on vaccine effectiveness and will adjust recommendations if concerns emerge around waning protection. Science is not static and understanding that evidence evolves and builds with time will help us in this time where studies related to COVID-19 are proceeding at breakneck speed.  We can be confident that recommendations will be refined or changed as new information comes forth and adds to the body of scientific evidence.

There are many uncertainties and nuances to COVID-19 vaccination policy, but this is clear:   all four Health Canada approved vaccines are safe and effective; all four vaccines are similar for outcomes we care most about – death and hospitalizations; getting any vaccine at the earliest opportunity makes the most sense.

To optimize vaccine uptake, government and public health officials need to build trust with the public through clear and transparent communication. Family doctors, public health nurses and other health care providers can put evolving information around vaccines into their patients’ personal health context and customize communication to address patients’ specific needs and allay their fears.  Trust and confidence will be as important to the success of this vaccine rollout as vaccine efficacy and safety. 

By Vamini Selvanandan© 2021. This work is licensed under a Creative Commons CC BY 4.0 license. This article was originally published in the Rocky Mountain Outlook on Thursday March 18, 2021. Photo credit: Thirdman on Pexels.com.

Recommended further reading:

Resilience and self-reliance key to pandemic recovery

COVID-19 vaccine shipments to Canada were reduced in recent weeks and Canadians have felt frustrated and helpless at being asked to wait.  We have watched with envy as other countries manufactured vaccines and inoculated their citizens.

Canada was similarly vulnerable at the beginning of the pandemic when countries scrambled to procure adequate supplies of masks, face shields and ventilators. With supply chains stretched out across the globe, we were at the mercy of other countries whose priority was to first provide for their own people.

But it doesn’t have to be this way.  Fifty years ago, Canada was a leader in vaccine production. A series of privatizations by the Mulroney government, followed by massive funding cuts to scientific research and development by the Harper government, eroded our ability to manufacture essential medicines and vaccines within our own borders.  Former and current Liberal governments have done little to rectify this situation.

Globalization and the desire to have efficient markets has resulted in Canada outsourcing and offshoring production of many essential goods and supplies needed for the well-being of Canadians. While cheap labour, less stringent workplace regulations and fewer environmental protections overseas might provide financial savings for governments, there is a cost to foreign procurement. When there is a spike in global demand for essential items, Canada has little control over when and if we will get what we need.

Our sovereignty as a country depends on being able to provide the basic necessities to all Canadians. Pandemic recovery requires that we invest more in Canadian production of vaccines, essential medicines and goods. Governments at all levels can support Canadian businesses by using public funds to purchase products and services locally. Investing in local research and development attracts business partnerships with scientific institutions and fosters job and economic growth for Canadians.

Resiliency and efficiency are desirable characteristics of systems. However, putting too much emphasis on efficiency at the expense of resilience can will leave us vulnerable and unable to respond to unexpected events. The COVID-19 pandemic has taught us that this is particularly true for systems like health care and long-term care.

We need to value quality and safety over economic efficiency.

Before the pandemic, cutbacks to the health care system have resulted in many large urban hospitals across Canada being over-stretched and operating at more than 100% hospital bed capacity on many days of the year. When the pandemic struck, we had no choice but to withdraw vital services like surgery or cancer treatment.

For decades, provinces have also been privatizing long-term care in the name of efficiency. But what we are getting through this process is unsafe care for our seniors and poor value for our money. Canada has the worst record among wealthy nations for COVID-19 deaths in long-term care homes.

There is abundant evidence that private for-profit homes provide inferior care compared to publicly-run seniors homes. Business practices such as inadequate staffing, overcrowding of residents and fewer health and safety protections are required to turn a profit for shareholders at the expense of quality care for our loved ones.

Instead, we need to build resilience into our systems. We need to value quality and safety over economic efficiency. We need to see the delivery of public goods like health care and senior care as the investments they are. We must not let politicians convince us that the well-being of Canadians, young or old, is a frivolous expense to be minimized.

We deserve to receive essential health services in a timely and dignified manner without long wait lists or care in hospital hallways due to lack of available beds. The health care system needs adequate staffing and funding so that it is not operating at or over capacity even in normal times. Creating a safety margin to accommodate unexpected or less frequent events like pandemics or natural disasters is part of good planning and emergency preparedness.

In the senior care sector, we need to hire adequate numbers of workers, provide them with appropriate training and ensure they have safe and decent working conditions.  We need to pay them wages and benefits to match the value of the services they provide.

Nobody knows when an end to the pandemic will be declared. But we don’t have to wait until then to build our capacity for resilience and self-reliance. The time to act is now.

By Vamini Selvanandan© 2021. This work is licensed under a Creative Commons CC BY 4.0 license. This article was originally published in the Rocky Mountain Outlook on February 18, 2021. Photo credit: Càetia Matos on Pexels.com.

Further Reading

CTV news. ‘We took our eye off the ball’: How Canada lost its vaccine production capacity

Unifor. Is Canada starting down the long road to long-term care reform?

Government of Canada. From risk to resilience: An equity approach to COVID-19 

Christopher Nemeth et al. Minding the Gaps: Creating Resilience in Health Care

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