Let’s shift the focus this election. Together, we can change the conversation to talk about health beyond hospitals and emergency departments.

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Let’s shift the focus this election. Together, we can change the conversation to talk about health beyond hospitals and emergency departments.

Election countdown

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Let’s talk about HEALTH this election. 
Healthcare alone can’t create health. But government policy can.
Both historic and current policies set the stage for health to either flourish or perish. Provincial policy decisions across all government departments affect health one way or another -way beyond the impact of hospitals and emergency departments.

Most Manitobans agree that good health is something they value greatly. But with so much focus on emergency care and wait lists, it’s harder to see that hospitals and emergency departments are not the solution for a healthier population.

Decisions made by elected officials affect all the conditions people need to be healthy throughout life. Things like sufficient income, good housing, good food, accessible public transit and active transportation infrastructure, education, a clean environment and a stable climate, freedom from racism and oppression, a secure, happy childhood and a community where everyone belongs are necessary for everyone to be as healthy as possible.

When governments don’t invest in the things that make us healthier, our collective health suffers, health gaps widen, and healthcare costs soar. Short term cost-cutting measures in healthcare will be quickly outweighed by an ever-sicker province needing more and more healthcare services.

Manitoba’s Government and elected officials need to:

  • recognize that every policy decision made in all departments affects the health of Manitobans and ensure that effective mechanisms are in place to consider the health impact of all policies.
  • invest in the things that make Manitobans healthier at the same time as providing quality health care once people are sick.
  • take a long-term view of health impacts beyond single term mandates to turn the corner on ever increasing healthcare spending for preventable illnesses and injuries.
  • commit to closing gaps in health such that the all Manitobans experience the same level of good health as the most wealthy, privileged Manitobans.

Election Issues

Government policy broadly affects all the conditions that impact health. For the 2019 provincial election we have focused on five priority issues that need urgent policy attention. Like all ‘determinants of health’, they are interconnected. Policy action in one area can have positive impacts in others.
Closing Gaps in Indigenous Health
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Early Childhood Development
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Climate crisis
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Housing
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Poverty
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Ask your candidates!

  • How are you and your party prepared to increase self-determination for health and social service planning, administration and delivery for Indigenous Peoples?
  • How are you and your party prepared to respond to the Calls to Justice from the National Inquiry into Missing and Murdered Indigenous Women and Girls?

Closing Gaps in Indigenous Health

Current public policy reflects a relationship between Manitoba and First Nations, Metis and Inuit peoples that fails to meet the health and social needs of Indigenous peoples. The contribution and historical legacy of colonialism is long-standing and the resulting present-day interpersonal and systemic racism that underlies the persistent health gaps must be addressed at all levels of health and social systems and government policies.

As stated in the Final Report of the National Inquiry into Missing and Murdered Indigenous Women and Girls (MMIWG) (2019), 

  • “Substantive equality” is a legal principle that refers to the achievement of true equality in outcomes. It is required in order to address the historical disadvantages, intergenerational trauma, and discrimination experienced by a person to narrow the gap of inequality that they are experiencing in order to improve their overall well-being. 
  • A decolonizing approach aims to resist and undo the forces of colonialism and to re-establish Indigenous Nationhood. It is rooted in Indigenous values, philosophies, and knowledge systems.

Implementing the Truth and Reconciliation Calls to Action and the MMIWG Calls for Justice must include a decolonizing approach. This involves recognizing inherent rights that Indigenous Peoples have to self-determination in relation to matters that are internal to their communities. 

Despite provincial and federal governing bodies’ reconciliatory efforts, current policies, procedures and overall function of health and social systems and structures are ineffective and continue to entrench, rather than disrupt, colonialism.

  • Establish “Substantive Equality”, meaning true equality in health outcomes for Indigenous Peoples, as the benchmark for planning and evaluating policy decisions as well as health and social services.
  • Support policies that ensure regional and provincial planning tables move beyond tokenistic Indigenous consultation and move towards meaningful inclusion. For example, ensure  representation of Indigenous persons on Regional Health Authority Boards is reflective of the population.
  • Support the removal of jurisdictional barriers that perpetuate health and service inequity in remote and rural First Nations.
  • Incorporate local Indigenous ways of knowing as a means for planning and evaluating policy decisions and health and social programs.
  • Implement the recommendations from the Transforming Child Welfare Legislation in Manitoba Report.

Ask your candidates!

  • How are you and your party prepared to increase self-determination for health and social service planning, administration and delivery for Indigenous Peoples?
  • How are you and your party prepared to respond to the Calls to Justice from the National Inquiry into Missing and Murdered Indigenous Women and Girls?

Early Childhood Development

Children should be the most loved and treasured part of any community. We know this on an emotional level, but it is also true on a practical and scientific level. Children with strong early childhood experiences, such as nurturing care, nutrition, housing, health care and quality child care, thrive. When children thrive in their early years, they grow into healthy, contributing citizens that benefits them and their communities for their whole lives.

Wise investments in the early years are the best short and long term investments a society can make. In Manitoba, we are a long way from where we need to be.  

  • Nearly a third of children start kindergarten not fully ready to learn.
  • Children who experience adverse circumstances are significantly more likely to arrive at school not ready to learn.
  • Imagine being 5 years old and already left behind which can contribute to a cascading range of negative health and other outcomes throughout life.
  •  In Manitoba, Indigenous children represent almost 90% of children in child welfare placements although they make up less than one-third of the population.
  • Apprehensions often occur for circumstances arising from poverty, not because of violence or abuse.  
  • Family separation has long-lasting effects on health. Child welfare apprehensions are associated with trauma, mental illness, fragmented health care, and homelessness after aging out of care.
  • Missed opportunities and negative experiences in the early years leave a permanent legacy that later materializes in poor mental and physical health, lack of employment, and dependence on publicly funded systems. 

Without change we will continue to place undue stress on children and their families and a heavy economic burden on our economy – now and into the future. The good news is we can make a huge difference.  We just need to decide that all children are worth it.

  • Connect with families prenatally to offer support and preparation for parenting. For those living in poverty include meaningful financial and social supports, including increasing the rate and reach of the Manitoba Prenatal Benefit.
  • Ensure that children and their families are sufficiently supported so that no child is removed due to inadequate housing, food or other basic needs.
  • Recognize the economic and social value of quality, licensed, not-for-profit Early Learning and Child Care and:
    • Expand the number of spaces available. 
    • Ensure affordability of spaces and access for all families.
    • Enhance child care subsidy provisions to meet the needs of working families living in poverty.
    • Modify policy to make access to quality child care a key component of child welfare prevention strategies. 
    • Value Early Childhood Educators through remuneration that recognizes their training and skills and the importance of their work.

Ask your candidates!

  • How will you support an increase in not-for-profit Early Learning and Childcare spaces?
  • How do you plan to improve family well-being and dramatically reduce the need to apprehend children?
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Ask your candidates!

  • How are you and your party prepared to respond to the health impacts of climate change?
  • How does your government plan to protect people who are disproportionately impacted by climate change including people living in rural and northern areas and people living in poverty?

climate crisis

Manitobans are already experiencing the adverse health effects of climate change and time is running out to prevent catastrophic impacts. The physical and mental health impacts of climate change have the potential to further burden our province’s publicly funded healthcare system. Prevention and adaptation to climate change is essential to reduce harmful health impacts and protect the health of every Manitoban.

The threat of climate change to health is undeniable and pressing. The impacts of climate change are unevenly distributed and experienced by people living across Manitoba.

  • As average temperatures continue to rise, so will heat-related illnesses.
  • Climate change increases the frequency, intensity, and duration of heat waves, droughts, wildfires, floods and storms.
  • Climate change influences the transmission of vector-, food-, and water-borne diseases.
  • Climate change threatens food and nutrition security.
  • Climate change poses threats to our mental health and well-being.
  • Communities in rural and northern regions are disproportionately impacted by climate change due to their higher reliance on the natural environment for their livelihoods, sustenance and cultural practices. 
  • People living without access to safe and quality housing, adequate income and social support networks are more vulnerable to the impacts of climate change.
  • Support sustainable and resilient food systems that, for example, reduce food waste, promote local food economies and encourage regenerative agriculture. 
  • Protect and restore ecosystems, including wetlands and forests, for carbon sequestration and other ecosystem services that help mitigate the impact of a changing climate
  • Invest in diverse renewable energy sources (e.g., wind, solar) to decrease the use of fossil fuels and improve air quality. 
  • Invest in active and public transportation to reduce transportation emissions and realize the health benefits (e.g. physical activity, improved mental health). 
  • Support community planning and invest in strategies that increase resilience and protect communities in the event of floods, droughts, heatwaves, forest fires and other disasters that may increase as a result of climate change.
  • Ensure health is considered and  integrated across all government climate change adaptation and mitigation strategies and policies.

Ask your candidates!

  • How are you and your party prepared to respond to the health impacts of climate change?
  • How does your government plan to protect people who are disproportionately impacted by climate change including people living in rural and northern areas and people living in poverty?

Housing

Housing impacts all aspects of health.  Stable affordable, good quality housing protects and promotes health, whereas the lack of the same affects health negatively.  When individuals and families cannot access good housing due to cost, they may have no other options than to live in places that are low quality, overcrowded, unaffordable, unsafe or abusive.  All levels of government have the responsibility to ensure that every member of society has access to good housing.

  • In Manitoba, 51,130 households are in core housing need (living in accommodations that are overcrowded, in poor repair or are unaffordable) and at risk of homelessness.
  • Well over 1 in 3 rental households, and 1 in 10 households who own their own home,  are paying more than they can afford for housing. This can cause stress and takes money away from essential needs (such as nutritious food, medications, transportation, household bills, clothing). 
  • Children who experience housing instability or homelessness have a 25% greater risk of poor health in adulthood and higher mortality rates in adulthood. Thousands of children in Manitoba are growing up in core housing need.
  • Income and lack of housing are the main barriers to finding housing among people who are homeless.  In Canada, people experiencing chronic homelessness often die prematurely in their 40s.
  • Every ten dollars spent on housing and supports for chronically homeless individuals results in an estimated $21.72 in savings related to health care, social supports, housing and involvement in the justice system.
  • Invest in new social housing  which gears rent to income using recommended target of 300 units per year.
  • Invest in affordable housing by public, non-profit and co-op sectors prioritizing new builds where and for whom it is needed most (e.g. low-income people, women, newcomers, Indigenous people, persons with disabilities, people experiencing homelessness, and youth exiting out of the care of Child and Family Services).
  • Extend rent subsidy agreements for existing rent-geared-to-income housing units for long term (at least 10 years or more) and invest enough to meet their capital repairs and maintenance now and in the long term. 
  • Maintain Rent Assist, increase maximum benefit to 75% Median Market Rent and reverse recent cuts to this program; support other strategies such as income supports and subsidies that are designed to be portable for very low income Manitobans. 
  • Do not transfer public housing assets to the private sector; and ensure the sustainability of rent-geared-to-income units if public housing assets are transferred from the public sector to the non-profit and/or co-op sectors. 
  • Include consistent funding for supports and resources for tenants within operating budgets of social housing, including higher levels of support for tenants with increased risks of eviction and homelessness. 

Ask your candidates!

  • How will you and your party support more housing options to ensure every Manitoban has access to quality housing that meets their needs and which they can afford?
  • What commitments have you and your party made to increase and maintain social housing options across Manitoba?
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Ask your candidates!

  • What poverty reduction policies do you propose to improve the basic conditions for health so that eventually less health care services will be needed?
  • Will you commit to increasing Employment and Income Assistance rates to cover the costs of basic needs?

Poverty

There is a clear relationship between health and poverty. Decades of research has shown that poverty is the most powerful determinant of health, including increased risk of disease, premature mortality and disability. Life circumstances and the environments in which we live profoundly affect how much control we have in our lives. Poverty robs children of their life chances, compromises secure employment and safe working conditions for adults,  and limits the opportunities for seniors to age as they wish. Low-income and stigma can exclude people from recreational opportunities, social networks and community life.

  • People who live in poverty experience worse health outcomes because of differences in historic and current access to money, power and resources. 
  • In particular Indigenous, racialized peoples, and persons with disabilities experience disproportionate rates of poverty, precarious and under employment, and discrimination within housing, education and health systems.
  • Manitoba has the highest child poverty rate (28.1%) of any province in Canada. Research shows children impacted by poverty are more likely to develop chronic health issues as adults. 
  • Some Manitobans have nearly two decades lower life expectancy than others, due to social and economic disadvantage.
  • Data show that 20% of the over $200 billion annually spent health care can be attributed to social and economic disparities in Canada. 
  • Poverty costs us all as it generates high health care, social service and criminal justice costs.

MPHA supports Make Poverty History Manitoba’s policy priorities for the 2019 election.

  • Target and Timeline: Create a comprehensive and adequate poverty reduction strategy, with targets and timelines for ending poverty and social exclusion in Manitoba based on current statistics.
  • Employment: Incrementally increase the minimum wage per hour to $16.58 per hour (equivalent to the Low Income Cut Off–Before Tax (LICO – BT) for a single parent with one child) and index annually to the LICO—BT.
  • Housing: Beginning in Budget 2020 invest in building a minimum of 300 net new units of rent-geared to income housing annually for five years.
  • Employment and Income Assistance: Introduce a livable basic needs benefit, set at a level to cover the actual cost of basic needs such as food, clothing, communications and transportation and combined with other income supports, to lift all Manitobans up to or above the poverty line.
  • Child Care: Add 17,000 new licensed, funded non-profit child care spaces by 2021 with priority given to low socio-economic neighbourhoods and immediately provide a full fee subsidy for families living below the poverty line.
  • Mental Health: Double funding for community-based mental health services that serve low-income Manitobans.

In addition to the above priorities, cuts to programs low income people rely on like Rent Assist and funding for community programs must be reversed.

Ask your candidates!

  • What poverty reduction policies do you propose to improve the basic conditions for health so that eventually less health care services will be needed?
  • Will you commit to increasing Employment and Income Assistance rates to cover the costs of basic needs?
Talk to your family, friends and colleagues about health. Together, we need to raise our voices and share evidence about election issues that matter most. Help spread #vote4publichealth messages through social media by sharing the quick facts below about issues you care about this election season.
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Help spread the message by posing quick facts about issues you care about this election season.

Check out the ‘Ask your Candidates’ sections. Contact your candidates to raise these important issues, ask them to respond to your questions, and remind them what influences your vote. It is a critical way to contribute to a healthier future for all Manitobans. And then be sure to vote! Encourage and assist others to vote as well. And once elected, MLAs work for you! Stay in touch with them.
Get Ready
Make sure you are registered to vote, know your riding, and have your current address on file with Elections Manitoba.
Ask Questions
When door knockers approach, engage them! Have your questions ready. You could also participate in an all-candidates forum in your riding.
Send a message
Email your candidates to let them know what you care about, or reach out to them through social media. Start by finding out who they are...
Vote
Know when, know where. Vote early to beat the crowds! And when it's all over, if you haven't already, be sure to introduce yourself to your new MLA.