For class this week, we had to read the Ottawa Charter for Health Promotion (World Health Organization, 1986) and the Millenium Development Goals (United Nations, 2010) and while the goals seem respectable and well-meaning, they fall almost laughably short.
The Ottawa Charter was made in the mid-1980s, around 25 years ago. That seems like reasonable time to be able to enact the sort of changes that are declared to be essential for health promotion. And yes, I realize that political climate plays a huge role in how much gets done in government, let us take a look more specifically at what areas we are still lagging in after all this time.
“The fundamental conditions and resources for health are peace, shelter, education, food,
income, a stable eco-system, sustainable resources, social justice and equity. Improvement in
health requires a secure foundation in these basic prerequisites”. (WHO, 1986)
We seem to be doing fine on the peace front here in Canada, but on the other “prerequisites”, not so much. In London alone there are massive cuts to public housing funding constantly and the numbers of homeless people in Canada are growing what with the prolonged economic downturn. And as the Idle No More movement reminded us, there are places in our own nation that people are living in what can only be described as “third world” conditions. It is not health promoting to have people permanently living in tents.
While higher numbers than ever are pursuing post-secondary education, the costs of education are rising to the point where it will soon be unafforable for many. With the teacher strikes going on around the province and constant government cuts to education funding and the removal of public health nurses from school in terms of health education, especially in rural areas, education is beginning to suffer as well.
With the economy being in its current state, food bank use is at record highs across Canada and because of summer droughts, food prices have risen, especially on healthy choices like fresh produce. Income for most can hardly be seen as reliable when people are constantly being laid off in many sectors like finance and manufacturing, or at the very least having their salaries slashed in order to cut operating costs. And this is not the first recession since the Ottawa Charter was made.
With global warming on the rise and the Harper government’s decision to lift protective measures on thousands of lakes and rivers in Canada, it is impossible to say that we have a sustainable eco-system or sustainable resources.
And one only has to look at the statistics on women in the work place or the staggering numbers of rapes that go unreported per year in Canada to know that we hardly have equality for all or social justice. And that is just for one group, nevermind inequality that still exists towards people with disabilities, LGBTQ people and ethnic or religious minorities.
It would seem that not much has been done to ensure equal opportunities for health for all (WHO, 1986) when these huge social issues still exist and there are still massive disparities in access to care and living conditions amongst the population.
Also, as I have learned in two health studies courses in my time here at Western, health policy is not intersectoral by any means and is continually being downgraded on the agendas and being push to lower levels of government. Policies are convoluted and piecemeal at best due to poor knowledge translation and a clear lack of focus.
It is very clear that Canada has not honoured its “Comitment to Health Promotion” (WHO, 1986).
And then there are the Millenium Development Goals. Developed in 1995, the nations who signed onto this plan gave themselves 20 years to eradicate some pretty lofty goals: eradicate extreme hunger and poverty, primary education for all, gender equality and empowerment for women, reduce child mortality, improve maternal health, combat malaria, HIV/AIDS and other major world killers, environmental sustainability, and global partnership (UN, 2010).
First of all, global partnership is not going to be achieved when there are so many wars still being waged and so many sanctions on nations due to internal wars or actions that we disagree with.
As long as there are toxic levels of air pollution in China and an innumberable amount of other offences being committed against the environment currently, we are not going to reach the sustainability goals. Also, with 8 billion people on Earth and so many people against the idea of growing food in labs through genetic modification, we will never be sustainable- the carrying capacity of the Earth is just not high enough without artificial measures being taken.
Gender equality and empowering women is the one that disappoints me the most. With three years to meet the goal and this: http://thediplomat.com/2013/01/09/indias-women-problems-its-not-just-about-rape/ still needing to be pointed out, never mind this: http://www.rolereboot.org/culture-and-politics/details/2012-12-a-letter-to-the-guy-who-harrassed-me-outside-the-bar we are ludicrously far from equality for women, even in the so-called “first world”. There are still nations where women are being shot in the head for demanding the right to education (one of the Millenium Goals, might I add) and as long as language is still gendered and as long as rape still happens, whether it be through gang-rape on a public bus or date-rape at a frat party, women will never be truly equal. And that is a problem that cannot be fixed in three years. Why more progress hasn’t been made in 20 years is sickening and confusing to me.
As for the others, yes, it is nice to be able to point out that some progress has been made in a few nations. However, reaching 70% of a goal or a 90% reduction in something bad in three or four places mentioned is a) not 100% completion in these isolated examples with three years to go and b) forgetting about the other 200-odd countries in the world where far less progress has been made.
All I can say is the world needs to get its act together. These articles made me disappointed in humankind. History keeps repeating itself but no one seems to be paying attention to that fact.
World Health Organization (1986). Ottawa Charter for Health Promotion. Retrieved from: https://owl.uwo.ca/access/lessonbuilder/item/8946065/group/9ac87e36-4b9a-46fa-a48d-31d8cfa910e8/Week%203%20-%20Global%20Health%20Promotion:%20foundational%20concepts%20and%20historical%20perspectives/WHO%20-%20ottawa%20charter%20for%20health%20promotion.pdf
UN Department for Public Information (2010). Millenium Development Goals at a Glance. Retrieved from: https://owl.uwo.ca/access/lessonbuilder/item/8946086/group/9ac87e36-4b9a-46fa-a48d-31d8cfa910e8/Week%203%20-%20Global%20Health%20Promotion:%20foundational%20concepts%20and%20historical%20perspectives/MDG%20fact%20sheet.pdf