|
|
|
THE QUALITY OF LIFE IN ONTARIO SPRING 1999
For:
THE QUALITY OF LIFE IN ONTARIO SPRING 1999
INTRODUCTION The Quality of Life in Ontario has recovered almost to the level of 1990. But there is a growing "social deficit." This deficit reflects the failure of society to care for its vulnerable populations. It refers not only to the immediate consequences of unmet basic needs, such as hunger and homelessness, but also the long term damage it inflicts, especially on the life chances of children. This is the trend revealed by the Quality of Life Index in the Spring of 1999. This report is the fourth in the series on The Quality of Life in Ontario, which is published by the Ontario Social Development Council (OSDC) and the Social Planning Network of Ontario (SPNO). We are using the Quality of Life Index (QLI) as a tool to measure and monitor changes in living and working conditions which affect the quality of life in our communities. There are twenty community partners across Ontario involved in the QLI project, using the Quality of Life Index to measure changes in their local communities (see Appendix 1). Their results are reported here along with the provincial QLI.
DEFINING "QUALITY OF LIFE" We have developed this definition of "quality of life", based on our research into quality of life, determinants of health, sustainable development, and human and social development. For more information, see the QLI Literature Review (Appendix 2).
THE QUALITY OF LIFE INDEX (QLI) The QLI is a composite index which includes twelve indicators, three from each of four sectors - social, health, economic and environment. It was conceived, designed and developed by OSDC and SPNO as a tool for community development and action to improve the conditions which affect our quality of life. For more information about the criteria used to select these indicators, please refer to the QLI Methodology Report (Appendix 2).
We have collected the latest data available for each of these indicators for inclusion in the QLI. (In some cases, the latest data is one or two years old.) The method of calculating the Index is illustrated in Appendix 3.
We are introducing a new indicator in this report to replace suicides, since the data for suicides was unreliable. We conducted a thorough search for a replacement indicator, guided by our criteria for selecting indicators: relevant to the quality of life; data collected and available; reliability of data source; data is sensitive to changes over time. The new indicator we have selected is - new cancer cases - the number of new cases of all types of cancer for all ages, as collected by the Ontario Cancer Registry. Cancer touches the lives of most people in our society. It is one of the leading causes of death and affects the quality of life of patients, families and friends. The Harvard Report on Cancer Prevention summarizes what we know from epidemiologic research on what does and does not cause cancer in the United States. Each chapter reviews the recent literature on several potential sources of cancer risk (e.g., smoking, diet, obesity, occupational exposure, environmental pollutants) and offers a consensus statement on what the evidence tells us at this time. (www.hsph.harvard.edu/Organizations/Canprevent/contents.html) One of the most important conclusions to be drawn from this report is that cancer is indeed a preventable illness. Nearly two-thirds of cancer deaths in the US can be linked to tobacco use, diet, obesity, and lack of exercise - all of which can be modified through action, both at the individual and societal level.
Socio-economic Status Numerous reports from different countries have confirmed that economically disadvantaged groups in society are at increased risk of cancer. Cancers of the lung, stomach, and uterine cervix, and possibly other cancers as well, are particularly common among poor and underprivileged population groups. Poverty may be thought of as an important underlying cause for these cancers, since it is associated with increased exposure to tobacco smoke, alcoholism, poor nutrition, and certain infectious agents. If poverty is not always associated with increased incidence of cancer, it has been shown repeatedly to be related to poorer survival following the onset of cancer. Sufficient evidence had accumulated on low socio-economic status and increased cancer risk for the director of the United States National Cancer Institute (NCI) to declare in 1991 that "poverty is a carcinogen." If something is to be done about reducing socio-economic disparities in cancer, we must look beyond the explanation that such differences result from the health habits of the poor. This is because socioeconomic differences in health arise not just as a consequence of personal choice, but also because of constraints posed by the social environment in which people lead their lives. Socio-economic disparities in cancer are large, persistent, and possibly widening. The solution to reduce such disparities must take many forms: from action at the broadest level of society - such as social policies designed to alleviate both absolute and relative deprivation - to interventions at the level of communities - such as campaigns to remove cigarette vending machines and billboards - that help deprived neighborhoods overcome cancer. It is increasingly evident that fighting cancer also requires war on poverty. Reducing socio-economic disparities in cancer incidence and survival must involve interventions at the societal level, such as policies to alleviate poverty or to provide universal health care. Individual behavior change alone is unlikely to suffice.
Public concern about environmental carcinogens appears to be out of proportion with the true risk. The search for carcinogenic agents from environmental pollution has been a very active area of research, yet few causal links have been firmly established. Investigations have focused on water fluoridation, chlorinated water byproducts, metabolites of organochlorine pesticides (e.g., DDT), and residential proximity to hazardous waste sites or contaminated wells. Ecologic studies have indicated higher mortality from lung cancer in urban areas with high air pollution levels than in rural areas. On the other hand, epidemiologic studies have not documented an increased risk of lung cancer among nonsmokers living in urban rather than in rural areas but do suggest higher risks for urban smokers compared with rural smokers.
TRENDS IN THE QUALITY OF LIFE - 1990-99 The Quality of Life Index has rebounded to 99.9 in the Spring of 1999, which brings it almost back to the base value of 100 in 1990. This seems to be good news. But it has taken nine years to recover from the major economic problems we had in the early '90s. However, the recovery is not complete because of a growing "social deficit" which has short term and long term implications. See Sectoral Trends for more information.
A closer look at the performance of each of the indicators (see chart on next page) shows that the main areas of progress have been in the environmental indicators, low birth weight babies, and social assistance. There are setbacks in public housing, child welfare, long term care, new cancer cases, and bankruptcies.
PROGRESS We analyze the performance of each of the twelve QLI indicators in terms of progress and setbacks. This enables us to report in a balanced and comprehensive way about these key indicators of the quality of life in our communities. Tonnes Diverted to Blue Boxes - This has been a positive trend up to 1997. Since then, the Blue Box recycling program has been threatened by the effects of provincial cutbacks in funding for municipalities, the downloading of responsibility for waste management to local governments, and the variable market for recycled materials. It's interesting to note that this positive trend reflects the importance of citizen participation to make it successful. The data for 1998 will be available this summer and will be included in our next report in the Fall of 1999. Spills - New data for spills shows that the trend of declining reports to the Ministry of Environment and Energy (MOEE) continues through 1998. Ministry staff suggest that this is due to the tendency for people to report more significant spills, rather than trivial ones. The question of what kind of spill is reportable is up to the spiller, depending on the adverse affects of the type and quantity of the spill. There is a new regulation (Jan/99) which identifies 11 classes of exemptions from reporting. A guide for reporting is also being developed for use by companies and the public. Air Quality - The 1997 data for air quality shows a positive trend of fewer hours of moderate to poor air quality. Meanwhile, there are many reports of growing problems with air pollution. See Context for more information. The number of monitoring stations has been reduced from 34 to 27, which may have affected the Air Quality Index used by the Ministry of Environment and Energy. Many communities that are not within range of the remaining sites (27) don't have any information about their air quality. Low Birth Weight Babies - This encouraging trend of fewer low birth weight babies being born during the '90s could be attributed to the effects of pre-natal, nutrition, and parent education programs provided by health units, community health centres, social agencies and community organizations. Social Assistance Beneficiaries - There is a significant decline in the number of people who are receiving social assistance. This seems to be good news. But the reasons for this decline are complex and not fully understood. Surveys done of people leaving welfare by the Ministry of Community and Social Services and by Workfare Watch, an independent monitoring group, have found that more than 50% of people leaving social assistance are finding jobs with low wages and no benefits. But many others have not been located because they have no phones, have moved, or have lost their housing and are staying in shelters. Stricter rules of eligibility and enforcement have resulted in people being taken off the welfare rolls with no other options for income support. This good news story has a dark underside that puts its apparent progress into question. Growing problems of homelessness and hunger have been well documented. Local follow-up studies are being done in Hamilton, Halton, and Sault Ste. Marie. SETBACKS Children Admitted to Child Welfare - Child welfare authorities report that more children are being admitted to care for economic reasons, such as lack of housing or food insecurity, than in previous years. Over 80% of families on the caseloads of Children's Aid Societies are living in poverty. Amendments to the Child and Family Services Act were made in May, 1999 that will allow child welfare authorities to take action to protect children who are at risk of emotional abuse or neglect. This new legislation will tilt the scales of child welfare away from the principle of "least intrusive alternative" toward protecting the "best interests of the child" above all. This is likely to result in more admissions to care. The question of whether child welfare agencies will have adequate resources to handle more children is unanswered at this time. From the child welfare perspective, more admissions may be seen as a good sign that children are being better protected from adverse family conditions. From a quality of life perspective, higher admissions may suggest a failure on the part of our society to adequately support parents in raising their children. Public Housing Waiting Lists - The rising number of people on waiting lists for public housing represents our biggest setback in the Quality of Life Index since 1990. This is a result of federal and provincial governments getting out of the business of building and maintaining social housing for people who cannot afford market rents. Responsibility for social housing has been downloaded to municipalities, which have fewer resources to cope with the problem. The social housing stock is static and deteriorating. The situation has been worsened by the repeal of rent controls and the growth in market rents. The private sector has not picked up the slack by building new rental accommodation which is affordable. See Context for more on this issue. Elderly Waiting for Long Term Care - The number of elderly waiting for long term care placements is a growing problem, in spite of government announcements about funding being committed to long term care. The flow of funds into the system is slow in coming and is spread out thinly over an eight year period. Considering the time it takes to get new beds up and running, it is likely that the waiting lists will continue to grow in the short to medium term. This will put added pressure on families, as well as on social and health services, to cope with the needs of this population. The demographics of a steadily aging population cast a long shadow over the future health and well-being of our older citizens. New Cancer Cases - This new indicator that we have added to the QLI shows a small negative trend since 1990. Socio-economic disparities in cancer are large, persistent, and possibly widening, as noted earlier in this report. Data for 1997, which will be available this summer, may show whether this is a growing problem or not. See Context for more on this issue Bankruptcies - The number of bankruptcies reported to the Superintendent of Bankruptcies has declined from record levels in 1996, but it is still a significant setback from the good news about economic recovery. A recent report in the Globe and Mail notes that "two consecutive years of decline is noteworthy, considering that bankruptcies had been on a steady climb since 1980." (May 3, 1999). Industry Canada analysts indicate that better business management, not just better times, has been keeping companies afloat. A strong economy helps, but decisions made at the micro level seem to matter more (Ibid.). This is still an important measure of economic distress which affects the quality of life of individuals and families relying on income from business for their livelihoods. Labour Force Working - The number of people working has almost returned to the level of 1990, before the major recession of the early '90s. When population growth is taken into account, the recovery is not complete. This is still a setback in our view, when other aspects of the labour market are taken into account, such as the decline in per capita income in the '90s. See Context for more information. Labour Force Unemployed - The number of people who are unemployed has declined almost to the point where it was in 1990, before the major recession of 1991-93. We've regained lost ground, but have made no progress on the problem of unemployment. Evidence from other sources suggests that there are growing problems with underemployment and the replacement of good jobs with livable wages by low wage jobs with no benefits (See The Quality of Life in Ontario - Fall 1998. Appendix 1) See Context for more information.
We decided to take a look at the sectoral trends for the QLI indicators to see how the progress and setbacks are distributed. It shows a disturbing undercurrent to the QLI. When the social, economic, health and environmental trends are plotted separately, we get this pattern.
The health trends have declined by 10%, with two out of three indicators having a lower QLI value in 1999. The lone positive trend is the steady decline in low birth weight babies. The trend line from 1990-95 is holding close to the base value because the base year for long term care data is 1996. This means that the value of this indicator was held constant at the base value from 1990-96, neutralizing its effect on the QLI until 1997. The economic indicators have shown a 14% decline since 1990. They have also had the most dramatic change over the period, with a steep decline in 1992, followed by an up and down cycle, with a strong recovery in 1999. The labour market indicators, people working and unemployed, have shown significant improvement, but bankruptcies continue to be a strong negative trend. The environmental trends are very positive, with the QLI value for Spring 1999 being 43% higher than the base value in 1990. Though all three environmental indicators have shown steady improvement, there are major concerns being raised by environmental groups about the state of our environment. See Context for more information. A more detailed picture of these trends is presented by the charts on the following pages. SOCIAL TRENDS
One of the three social indicators,social sistance beneficiaries, has shown a significant numerical improvement over the past few years. While this trend has had a positive impact on the QLI, it is not all good news. Changes in social assistance rates, eligibility and entitlements have adversely affected many people trying to survive on welfare and are closely linked to reduced caseloads. See Context.
HEALTH TRENDS
But the growing waiting list of elderly waiting for long term care is a serious problem.
Our new indicator, new cancer cases, has shown a negative trend from the base year for data to 1996. We will see how the 1997 data affects the trend.
ECONOMIC TRENDS
ENVIRONMENTAL TRENDS
Air quality is showing improvement. But there have been independent reports of serious problems with air pollution in the last two years. See Context.
The steady decline in spills reported to the Ministry of Environment and Energy is good news. But the decline is related to reduced industrial activity and reduced regulations that rely on voluntary reporting.
CONTEXT FOR THE QUALITY OF LIFE INDEX The QLI, like any tool, has its limitations. Its main limitation is the use of only twelve indicators to measure such a complex concept as "quality of life." The QLI is meant to provoke public discussion of issues affecting our quality of life. It's not intended to be the last word on the subject.
To compensate for this limitation, our Fall 1998 report included information on key trends and issues in the four domains of quality of life as a larger context for interpreting the trends identified by the QLI. We continue this feature by reporting on the latest developments which affect our quality of life in Ontario.
Health and Wealth
But the National Forum on Health (1996) found that "governments and public administrators have not demonstrated in their decisions any appreciation of the impact of social and economic determinants and their impact on the health of individuals and communities."
Income and Child Well-Being
Homelessness - A National Disaster Homelessness has been declared a national disaster by cities across Canada and by the Big City Mayor's Caucus of the Federation of Canadian Municipalities. The United Nations has issued two recent reports that express "grave concerns" about the problem of homelessness in Canada as a violation of human rights (December, 1998, April, 1999). More people are living on the streets, shelters can't keep up with the need, more families are camped out in shelters and motels.
A new study on housing needs by the Ontario Non-Profit Housing Association (ONPHA) and the Cooperative Housing Federation of Canada - Ontario Region (CHF Ontario) sheds more light on the issues (April, 1999) The findings prove that the housing crisis isn't restricted to Toronto. All eleven centres in the study reported a huge and growing problem. Homelessness is a complex issue. It represents
the failure of our society, our governments, and the marketplace to provide
adequate and affordable housing for everyone. It is a violation of our
basic human rights. What can be done to address the problem?
A new study by Statistics Canada reports that family incomes have been stagnant in the 1990s (Toronto Star, April 15, 1999). The findings underscored the problem Canadian families have had getting ahead during a decade marked by prolonged high unemployment and cuts in government assistance. A report by the Urban Futures Institute, A Decade of Jobs and Pay in Canada: A Perspective on Canada's National and Regional Economies, says that Ontario has lost more jobs per capita than any other province over the past ten years (Toronto Star, March 31, 1999). Ontario has also suffered the biggest decline in payroll per capita (7.2%).
The QLI's environmental indicators have recorded positive trends since 1990, which have had an upward effect on the QLI. The Spring 1999 report continues to show this trend. But we have qualified this "progress" with a caution about looser regulations, ministry cutbacks reducing its capacity for inspections, fewer sites for reporting air quality, and the impacts of cutbacks and downloading on municipalities. All of these factors threaten our environment.
The report also notes that, "environmental information is simply no longer being gathered and made available to the public. The province has also terminated reporting on its own environmental activities." This has direct implications for the Quality of Life Index. We have previously reported on the problems we have encountered with getting data on air quality and the implications of seven fewer reporting sites across Ontario. An Environmental Agenda for Ontario
The agenda is laid out in five areas with policy and program recommendations in each area: Cancer
The Quality of Life Index is being used by twenty community partners in the QLI project to monitor and measure changes in local living conditions. The same methodology and data set is used by the provincial and local reports so that comparisons can be made and trends monitored. This is one of the greatest benefits of the QLI, its comparative framework based on a common set of indicators. It allows communities to compare their progress on improving the quality of life in three ways:
The following chart shows local QLIs, based
on reports done by our community partners. See Appendix 4 for the Bibliography
of Local QLI Reports.
Quality of Life and Public Policies Our quality of life has been the subject of public debate from many different points of view this spring. The trends and issues we have identified through the Quality of Life Index provide a basis for raising issues of public policy for attention by the newly elected provincial government. As a public service, we suggest a few: There are many more questions that could be raised about the issues which affect our quality of life.
CLOSING COMMENTS We hope that you will find this report to be both informative and useful to you in your own work on improving the quality of life in our communities. Our next report will be released in the Fall of 1999. Watch our website for the latest news on the Quality of Life Index project. Report by: Malcolm Shookner Ontario Social Development Council May 31, 1999
Appendix 1 QLI Community Partners The Complete list of QLI Community Partners is available by clicking the link on the menu at the left.
Appendix 2 QLI Background
Papers (Some of these Documents are available upon request.
Use the link on the menu at left for Requestion Documents.) The Quality of Life in Ontario - 1997 (disposiblé en francais) The Quality of Life in Ontario - Spring 1998 Annotated Bibliography Literature Review Methodology Report (disposiblé en francais) Reference List Summary of Indicators For more information contact: Ontario Social Development
Appendix 3 QLI Spring 1999 Spreadsheet
Appendix 4 Bibliography of Local QLI Reports Algoma Social Planning Council, The City of Sault Ste. Marie: Quality of Life Index Preliminary Report, January, 1999. Community Development Council of Quinte, The Best Place to Live in Ontario? The Quality of Life Index Project Report, Fall/Winter, 1999. Community Social Planning Council of Toronto, Quality of Life Index: A Report Card for the City of Toronto, Summer/Fall 1998, May, 1999. Halton Social Planning Council and Volunteer Centre, The Quality of Life in Halton, 1997, 1999. Lakehead Social Planning Council, The Quality of Life in Thunder Bay, Fall, 1998, Spring, 1999. Peterborough Social Planning Council, Quality of Life in Peterborough: Measuring what we value,1998. Social Planning Councils of Cambridge, North Dumfries, and Kitchener-Waterloo, Quality of Life in Waterloo Region, March, 1999. Social Planning Council of Kingston and Area, The Quality of Life in Kingston and Area, 1998. United Way/Community Services of Guelph and Wellington, The Quality of Life in Guelph and Wellington County, 1997, 1999.
Canadian Council on Social Development, Personal Security Index 1999, Ottawa, April, 1999. Canadian Institute for Environmental Law and Policy, Ontario's Environment and the "Common Sense Revolution": A Four Year Report, Toronto, April, 1999. Canadian Institute for Environmental Law and Policy and the Ontario Environment Network, An Environmental Agenda for Ontario, Toronto, April, 1999. National Forum on Health, Advancing the Dialogue on Health and Health Care: A Consultation Document, Ottawa, 1996. Ontario Non-Profit Housing Association and Co-operative Housing Federation of Canada, Where's Home? A Picture of Housing Needs in Ontario, Toronto, 1999. Ross, David P. and Roberts, Paul, Income and Child Well-being, Canadian Council on Social Development, Ottawa, May, 1999. Towson, Monica, Health and Wealth: How Social and Economic Factors Affect our Well Being, Canadian Centre for Policy Alternatives, Ottawa, 1999. United Nations Committee on Civil and Political Rights, Report on Canada's Compliance with the International Covenant on Civil and Political Rights, New York, April, 1999. United Nations Committee on Economic, Social and Cultural Rights, Report on Canada's Compliance with the International Covenant on Economic, Social and Cultural Rights, Geneva, December, 1998. Urban Futures Institute, A Decade of Jobs and Pay in Canada: A Perspective on Canada's National and Regional Economies, Toronto, 1999. Wilkinson, Richard , Unhealthy Societies: the Afflictions of Inequality, London: Routledge, 1996. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
© Ontario Social Development Council & Social Planning Network of Ontario |
