Changes to social assistance: Québec's Directors of Public Health ask the MESS not to apply the new Regulation and to evaluate its health impacts

MONTREAL, April 11, 2013 /CNW Telbec/ - In a document asking the Ministère de l'Emploi et de la Solidarité sociale (MESS) not to apply the changes to social assistance proposed last February, Québec's Directors of Public Health speak with one voice. "Despite the possible modifications announced this week by Ms. Maltais, we all still agree: It is essential to first conduct an evaluation of the impacts on the health of people targeted by these changes, in accordance with the Public Health Act," says Dr. Richard Massé, Montréal's Director of Public Health.

25,000 Québec households targeted
More than 25,000 Québec households are targeted by the new Regulation. According to the Directors of Public Health, the amendments to social assistance could have negative effects on the health of thousands of families, adults and children by further impoverishing them. "We absolutely have to avoid making people already living below the poverty line even more vulnerable," says Dr. Gilles W. Grenier, Director of Public Health for de la Mauricie et du Centre-du-Québec. Poverty is associated with the development of numerous chronic diseases, with mental health problems, and with development delays in children. In addition, child poverty can have lifelong health effects.

Surviving under the low income cutoff
Currently, social assistance benefits only cover about 50% of the basic needs of a person who lives alone and is able to work, and about 76% of a young family's basic needs. The new Regulation will do away with the $129 temporary limited capacity allowance granted to couples with children under 5 years old and to people aged 55 to 57 who are able to work. Moreover special benefits covering the costs of accommodations for people receiving addiction services would be limited to 90 days per year.

Clarification of employment assistance measures
In a document entitled Modifications à l'aide sociale : Éviter l'irréparable en évaluant d'abord les impacts sur la santé, the Directors also ask for clarifications regarding measures proposed in the Regulation that concern return to work, especially those pertaining to duration of allowances, admissibility criteria and support provided to individuals. The Directors point out that for some people, integration into the labour market can be difficult because of the particular conditions of some social assistance recipients deemed able to work. "A low level of education, long absence from paid work, difficulties with integration faced by immigrants, and the realities of the labour market in some regions of the province are major obstacles to returning to work for many people. In addition, existing prejudices against people on social assistance can prevent them from finding work," explains Dr. Ariane Courville, Interim Director of Public Health for Gaspésie-Îles-de-la-Madeline.

Health impacts of poverty
Generally, the most deprived individuals have the lowest life expectancy: in Québec, the life expectancy for the poorest men is eight years less than for the richest men; the difference among poorest and richest women is four years. In Canada, for instance, rates of diabetes and heart diseases are twice as high among the poorest group than among the richest. Disadvantaged socioeconomic standing is also associated with fewer years in good health. Moreover, people living in the poorest households are more likely to have high rates of psychological distress and serious suicidal thoughts.

The health costs of poverty
Poverty is very costly for the health system. According to a 2009 MESS study, improving the incomes of the poorest individuals would reduce Québec's healthcare costs by $1.7 billion every year. Studies have also shown that more low-income individuals are hospitalized and that duration of hospitalization increases with lower income, which is very costly for the health system.

The role of regional Directors of Public Health
Public health departments in Québec are responsible for disease prevention, and for monitoring, protecting and promoting population health. More specifically, and as established in the Public Health Act, regional directors of public health have a legal mandate to "promote health and the adoption of public social policies capable of fostering the enhancement of the health and welfare of the population among the various resources whose decisions or actions may have an impact on the health of the general population".

To access the position paper, go to www.dsp.santemontreal.qc.ca

SOURCE: Agence de la santé et des services sociaux de Montréal

Marie Pinard
Direction de santé publique, Agence de la santé et des services sociaux de Montréal
514-528-2400, ext. 3471

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