Advocacy for children
She was a nine-year-old skinny girl with a toothy smile and worn clothes, who told me her biggest wish was to enrol in dance lessons.
She was good at school but missed a fair amount of time because her single mom was sick a lot. Also, she didn’t have lunch that day and was really hungry, so I popped out of my office on the pediatric ward of the Cape Breton Regional Hospital in Sydney, raided our ward fridge, and brought her back a banana.
That was more than 10 years ago. I often wonder what happened to her. The odds were not in her favour. She was one of the many kids growing up in deep and persistent poverty in Nova Scotia.
Fifty per cent of our health status comes from our genetics, physical environment and access to health services. The other important 50 per cent comes from our social status — our income, level of education, social networks, housing and food security and early child development.
The 2019 Report Card on Child and Family Poverty in Nova Scotia, led by my colleague Dr. Lesley Frank, an Acadia University sociology professor, is important reading.
We are not doing well in Nova Scotia. One in four of our kids live below the poverty line. That’s 40,710 children.
We have some of the highest rates of child poverty in the country, and the only province where these rates worsened between 2015-17.
Infants and children from First Nations, immigrant and African Nova Scotian communities fare the worse, as do women, people with disabilities and those living in rural areas.
The good news, if we as a society choose to act, is that Frank provides us with lots of well-considered policy remedies.
I know we have smart and caring politicians, civil servants, business people, university academics, educators and others who have given this issue a lot of thought.
Nova Scotia is to be commended for its new pre-primary program, pharmacare program, dental and vision benefits for pre-teens and Kid Sport programs. But these programs are only a start.
Income assistance, which is too little and not indexed to inflation, low minimum wages, lack of universally accessible childcare and affordable rental housing, and costly post-secondary education, are all still major obstacles.
The recent federal Canada Child Benefit lifted hundreds of thousands of kids out of poverty, but the feds could have asked the provinces to match the benefits to have an even bigger impact.
André Picard of the Globe and Mail wrote “poverty unleashes a cascade of bad consequences.” For kids living in stressed households, poverty can have permanent negative developmental impacts, starting with premature births. Hungry and stressed kids don’t do as well at school.
Poor kids are at greater risk of negative lifetime health problems — depression, diabetes, cancer, heart disease, addictions, social exclusion and loneliness and injuries. Even drowning — swimming lessons are not free.
How does a parent living below the poverty line (many of whom are the working poor) decide between the power bill or mom’s infected tooth; rent or winter coats and boots? Fresh fruit or scribblers?
Governments are also faced with tough choices. Resources are needed for health care, schools, roads, the environment and long-term care. Raising taxes may lose votes. However, the evidence shows that poverty costs all of us more in the long term if left unaddressed.
Provinces like Quebec, P.E.I., Manitoba and Newfoundland and Labrador that set short- and long-term reduction targets have had notable recent success in reducing their child poverty rates.
Recently, a young couple on income assistance, battered by poor nutrition and past family traumas, brought their infant daughter to see me. She was born prematurely. I had just come from a meeting with my physician colleagues, where we had concluded a new four-year physician contract agreement with the province, with funding increases of two per cent per year.
Clearly, and ashamedly, I have been spending time at the wrong negotiating table.
There are no medicines or vaccines for the ill health caused by poverty. After examining the infant, I asked the parents, what was it that they wanted for their baby daughter?
“A better life than we have,” they agreed. And out the door they carried her.
A future educator? An engineer or a police officer? Maybe a gifted dancer. More likely another sad statistic of lost human potential. She may not have good choices, but we as Nova Scotians do.
I can think of 40,710 reasons why.
Andrew Lynk is a Cape Breton pediatrician who is currently chair of pediatrics at Dalhousie University and chief of pediatrics at the IWK Health Centre. He practised community pediatrics in Sydney for more than 25 years.