Canadian’s interests lie in the wise investment of tax dollars. In health care funding, that means increasing investment in public health programs. To maximize value, these programs should be led by specialized community connectors who link patients with local services and resources.
This budget expansion is one that even fiscal conservatives, who generally favour reduced government spending, can support, because in the long term it can save money and improve health outcomes for all Canadians.
By increasing investment in public health today, we can decrease “curative care” investment (hospitals, physicians and drugs) in the future, and simultaneously improve the health of the population.
This is because public health initiatives like preventive and social care programs are proven to be the most effective long-term financial investments, as they address the social determinants of health.
Yet, the current health-care budget provides relatively minimal funding to public health. This is consistent with historical trends. On average, since 2000, federal and provincial/territorial governments have allocated a mere 7.5 per cent of the publicly funded health-care budget to public health initiatives and 63.7 per cent to curative care.
As health researchers and advocates for cost-value investments, we believe the Canadian government must address the lack of balanced health-care funding. Politicians should increase funding today towards preventive and social health programs.
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Why social determinants of health matter so much
Social determinants are the social factors that affect health. They influence up to 80 per cent of health outcomes and include factors like income, education, food security, housing, environmental conditions, social inclusion and employment.
For example, social determinants that influence food security and access to healthy nutrition impact the risk of heart disease, diabetes and obesity.
When left unaddressed, these factors can lead to expensive health-care interventions for chronic conditions, and increase dependency on emergency room services.
Why fiscal conservatives should support investing in public health
Like any strategic investment, the value lies not just in the initial gains, but in the long-term returns.
Currently, the health-care budget does not adequately fund clinical practitioners to address social determinants of health. The funding model prioritizes curing diseases rather than maintaining health. It overlooks the societal challenges that drive the increasing demand for future curative care. This places a significant burden on taxpayers, as they are tasked with funding these high-ticket health-care initiatives.
Increased spending towards preventive and social care programs can ultimately lead to improved health and well-being at a lower overall cost.
Reinvestment of this saved capital can bolster Canada’s overall financial stability, making this a sustainable approach.
We advocate that increased investment in preventive and social care provides excellent value for taxpayers — even those who support decreased government spending.
The question is one of value for money. It is not economical for taxpayers in a universal health-care system to deprioritize social determinants of health, given their profound impact on long-term health.
Community connectors as preventive and social care leaders
A recent approach to the provision of preventive and social care is “social prescribing.” Social prescribing is the identification and connection (most often by clinical practitioners) of individuals to community connectors, or directly to community social supports.
Community connectors are known by various titles such as community service workers, link workers or system navigators. Unlike social workers, community connectors do not provide direct interventions (such as counselling), but rather “prescribe” services like local food banks, or knitting clubs. They are specialists in preventive and social care.
We suggest that community connectors should oversee all aspects of social prescribing and management. Community connectors should accept referrals from both community members and their practitioners. This aligns with the approach taken with other specialty programs (e.g., physiotherapy).
This could also decrease the work for clinical practitioners who often lack the time and training associated with social prescribing.
In addition to excellent care, community connector-led programs are more cost-effective. The cost of co-ordination via community connectors is significantly less than adequately funding clinical practitioners to perform this role.
Canada requires fiscal discipline to focus on the root causes of health issues. Investing in community connectors could be a fiscally responsible strategy that can enhance overall health and provide better value for taxpayers.
Rylan Egan receives funding from the Henderson Foundation via Compassionate Communities Kingston Canada. In the past, he has received funding from the Canadian Institutes of Health Research (CIHR), and the Canadian Frailty Network.
Madison Lavergne receives funding from the Henderson Foundation via Compassionate Communities Kingston Canada. In the past, she has received funding from the Canadian Institutes of Health Research (CIHR), the Canadian Frailty Network, and the Mathematics of Information Technology and Complex Systems (MITACS).
