“The health-wealth gradient has been found time and time again,” said Dr. Andrew Pinto, a member of St. Michael’s family health team and Centre for Research on Inner City Health. “People who are poor have worse health and now we need intervention to actually do something about it.”
Pinto said the family health team at St. Michael’s has a cache of about 33,000 patients of which more than half come from low-income neighbourhoods. Although the hospital doesn’t track a patient’s income, Pinto said there is an undeniable relationship between a person’s income and where they live.
“There is a really close correlation between certain neighbourhoods and the average income,” he said.
That’s why starting in May a team at St. Michael’s will launch a research project to further understand how the health care system can promote greater financial stability in patients. Over the course of two years low-income patients will visit regularly with a health promoter, hired this past November, and learn financial management skills as well as gather an understanding of how wealth affects health.
“Part of it is because money allows you so much more freedom around certain things from what you eat to how you spend your time to access to service to also your ability to negotiate and advocate for yourself in the health care system,” said Pinto, who will lead the research project. “Even in our universal system we know that people who have a stronger voice and are better able to advocate for themselves are actually able to access certain services at a higher rate.”
Although the research project has yet to be finalized — it was before St. Michael’s internal research ethics board when Pinto spoke to The Register — he said thousands of the hospital’s low- income patients will immediately benefit by being involved in the research.
Along with helping the test subjects over the next two years, St. Michael’s hopes to develop a model for other primary health care services to integrate financial literacy into their care.
“We can learn from this how we can better simply address these types of things within the health care system and what other areas we could potentially work on,” he said.
Funding for the project is coming from a $95,000 TD Financial Literacy Grant, one of 19 grants recently distributed by Social and Enterprise Development Innovations (SEDI).
“Our mission is expanding economical opportunities for Canadians living in poverty,” said SEDI CEO Elizabeth Mulholland. “Since starting up (the financial literacy grants) we’ve found that many Canadians actually have low levels of financial literacy, but the impact on people living in poverty is actually much worse because they have very little room for error in managing their finances. So the consequences can be quite severe if they make a mistake.”
She said financial literacy “is the knowledge, skills and confidence to make the most effective use of your financial resources to achieve your goals and that might look different depending on who you are and the context and reality of your finances.”
Mulholland criticized the education system for not effectively teaching youth about finances.
“It just hasn’t been part of the school curriculum, although that is starting to change in a number of provinces including Ontario,” she said. “Also the financial marketplace has gotten a lot more complex in our lifetime. We actually need to know more than we used to need to know.”
And that’s what Catholic Family Services in Hamilton will be focusing on with its grant, which is also about $95,000. CFS will use the grant to host a number of financial educational programs, tentatively called Skills for Success, in the Hamilton area including an after-school program.
“We want to do this in schools and community agencies like Ontario early years centres,” she said. “We are working towards having it in Catholic and public elementary schools, kind of like after-school programs. They are going to be our future spenders so they need to know how to manage money at an early age so that they can do it successfully so they do not grow into huge debt when they get older.”
In addition to targeting students specifically Catholic Family Services will also host family education events, which the agency hopes to have started by May, where both adults and children will learn financial management skills. These seminars, which are to be hosted in a number of areas in Hamilton, will either be single day events or an eight- week program depending on the community.
And although the project at St. Michael’s Hospital and in Hamilton may seem like two completely different means of curbing poverty, they are seeking the same ends, said Mulholland.
“What we are trying to do is fill that (income) gap in a sense.”