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Hamilton is a city of stark inequalities. As the city’s economy booms, many Hamiltonians are swept to the sidelines as a result of a housing crisis and employment insecurity. Compared to other cities in Ontario, Hamilton also has a high proportion of working class people, disabled people and refugees, who are often the first to feel the brunt of these changes.

Health outcomes over the past decade have been bleak, and according to many disability justice and healthcare advocates, show no signs of changing unless bold steps are taken to support Hamilton’s marginalized populations.

 

The Code Red Project

In 2010, the Hamilton Spectator released Code Red, a project that mapped the connections between income and health across Hamilton to explore the social determinants of health. Using census and hospital data from 2006 and 2007, the report showed strong disparities in health outcomes between the Hamilton’s wealthiest and poorest neighbourhoods.

The Code Red project shows that social and economic inequalities lead to health inequalities. The lower city, which experiences disproportionately higher rates of poverty, also has significantly poorer health outcomes.

In February 2019, an updated Code Red project was released using data from 2016 and 2017. The updated Code Red project found that in general, health outcomes in Hamilton have declined and inequalities have grown.

Since the first Code Red project in 2010, the average lifespan in parts of the lower city has declined by 1.5 years. Furthermore, the gap in lifespan between Hamilton neighbourhoods has grown from 21 to 23 years.

 

Hamilton: the past 10 years

These results come as no surprise to Sarah Jama, an organizer with the disability justice network of Ontario. According to Jama, given the lack of political change coupled with changes in the city of Hamilton, it was inevitable that poverty would worsen and inequalities would deepen.

Jama notes that health care and social services tend to be compacted into the downtown core, which has tended to have a higher concentration of people who rely on these services.

However, rising costs of living within the downtown core has meant that the people who access these services are being priced out. According to a report by the Hamilton Social Planning and Research Council, eviction rates have skyrocketed in the past decade. As a result, the people who rely on these services have to make compromises about whether to live in a place with supports available close by, or a place that is affordable.

“The more compromises you have to meet with regard to your ability to live freely and safely in the city the harder it is to survive,” said Jama.

Denise Brooks, the executive director for Hamilton Urban Core, works directly with people at the margins of Hamilton’s healthcare system. Brooks noted that the 2010 Code Red project was a wake up call for many.  

“For me one of the biggest takeaways [from the first Code Red project] was even greater resolve that this really is a political issue and that it hasn't been looked at and is not being looked at as a crisis,” stated Brooks.

The 2010 Code Red project sparked projects including the Hamilton neighbourhood action strategy and pathways to education program. According to Brooks, while these initiatives were beneficial, more robust policy is needed to substantially address poverty.

“... [C]an we see any change in policy orientation? Did we see a reallocation of resources? Did we see a redistribution of priorities in any way? I would have to say no,” said Brooks.

 

Looking ahead

The updated Code Red project calls for a restructuring of the traditional health care system to include social and economic programs that contribute to people’s overall health.

However, recent political changes have led many health advocates to worry that the coming years will see change for the worse. Matthew Ing, a member of the DJNO research committee, notes that provincial cuts to a slew social assistance programs threaten to further exacerbate the existing inequalities in Hamilton.

In November 2018, the provincial government announced reforms to Ontario Works and the Ontario Disability Support Program that aimed to streamline social assistance and incentivize people to return to work. Among many changes, this includes aligning the definition of disability to align with the more narrow definition used the federal government.

According to Jama, narrowing the eligibility requirements for disability support makes it likely that people will slip through the cracks. They will put the responsibility on the municipality to provide services, meaning that care is likely to differ between providers.

“The onus is going to be on individual service providers on all these people to really decide who really fits this idea of being disabled enough to be on the service versus it being like sort of supervised by the province,” stated Jama.

Additionally, in February 2019 the provincial government announced plans to streamline and centralize the health care process. Under the proposed model, Ontario Health teams led by a central provincial agency will replace the existing 14 local health integration networks across the province.

Brooks noted that this has not been the first time that the province sought out to reform healthcare. Having worked in community health for years, Brooks remarks that the changes that are made to healthcare frequently exclude people on the margins.

“It's always the people who are the most marginalized, the most vulnerable, the socially isolated and historically excluded that remain on those margins all the time regardless of the change that go through,” said Brooks.

Currently, patient and family advisory committees work to inform the work of LHINs. The government has not announced whether PFACs will be retained under the new model, but Ing worries that a centralized model would leave patients and families out of the decision making process.

However, Ing recognizes that the current system is far from perfect, noting that disabled communities were not adequately represented on PFACs. According to Ing, this speaks to the much larger problem of political erasure of people with disabilities.

“Disability justice means that we must organize across movements, and we must be led by the people who are most impacted,” writes Ing.

The DJNO was created in order to mobilize disabled communities and demand a holistic approach to healthcare reform. According to Jama, this includes seeing race, income, and disability as fundamentally interconnected.

However as social assistance measures are cut at the provincial level, the future for disability justice is murky. The results of the updated Code Red project paint a sobering picture of the state of health inequality in Hamilton. Given the direction that healthcare reform is taking on the provincial level, health and poverty advocates worry about the future of healthcare equality in Hamilton.

 

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By Nina Gaind

Walking through Supercrawl felt different this year. I felt weird about the presence of five Toyota cars positioned directly across from an art installation. I also felt a bit out of place, as many local faces and businesses from the past had disappeared, replaced by shiny new coffee shops and boutiques. The unoccupied lot beside CBC Hamilton was empty, where in past years it has been populated by local artists selling their unique DIY crafts and teenagers hanging out in the back (do you know what I’m referring to?).

Despite these changes, the thing that made me the most uncomfortable was the couple comments I heard from Supercrawl goers, referring to Hamilton and the space they were occupying. I heard people making jokes while in a long time standing James Street North shop, laughing about how outdated and cringe it was. I heard people snickering at the presence of homeless folks, and making a joke out of the poverty in Hamilton. These deeply unsettling comments symbolize a larger problem with the changing scene in Hamilton, and the language people use causes further harm to the people being pushed out of these social spaces.

Growing up in a town on the edge of Hamilton, I noticed ways in which people spoke about Hamilton. People talked about the city’s poverty with disdain, associating low-income areas with crime, rather than compassionately understanding the drive behind the perceived danger. With the recent wave of gentrification, more people from outside of the downtown area have been spending time in in the downtown core, changing how the city is perceived. This is exemplified in streets like James Street North and Barton Street being described as “up and coming”, while not even 2 km away there are some of the highest poverty rates in the country. With this rapid gentrification, Hamiltonians who have historically occupied these spaces are being pushed further and further away from these areas. For example, an affordable housing project in the North End was recently bought out by investors, leaving people who relied on this without homes. As a student who spends time in these spaces, I listen as the language used to describe people of low-income neighbourhoods becomes increasingly harmful and offensive. Local Hamiltonians are spoken about in ways that stigmatize their lived experience calling certain areas “sketchy”, “ghetto” and “ratchet”. These terms are highly racialized and classist, and do nothing but further the marginalization low-income people face throughout the development of Hamilton.

This issue is highly complicated and has many layers to it. Gentrification is not a simple concept, as development in the city has positive and negative consequences. As a student, I want to use my voice and privilege to acknowledge the power I and my peers have when we occupy spaces downtown. Students are positioned in a very grey area when it comes to gentrification and development. On one hand, we are not the people directly investing and developing land in Hamilton, rising rent prices and pushing low-income folks to the margins. On the other hand, we engage and spend time in these new coffee shops and stores, supporting local businesses and enjoying these spaces. While we might think our presence as students is trivial, our identities as students give us social power. Our identities as educated individuals give us more mobility to access physical and social spaces than local Hamiltonians. It is important for us to be mindful of this fact and reflect upon how and why we perceive others to be different from us. This being said, I recognize that university students come from diverse  backgrounds and experience oppression in many aspects of society and this should not be ignored when talking about this issue.

This city belongs to the very Hamiltonians we ridicule. As we continue to spend time in gentrified areas in Hamilton, we should be aware of the language we use when talking about others, specifically marginalized folks who are being negatively impacted by the cities changes. Using divisive language feeds the narrative that people who live in poverty are bad and dangerous, which physically and socially separates people more in society. When we start to change the tone of how we describe others, it can help to create more respectful relationships between people we may deem different from us. We must respect the history of Hamilton and recognize presence of poverty, looking to the root causes of inequality. I am hopeful that we as students can continue to enjoy Hamilton while being mindful of our identities and interact more positively with local Hamilton community members.

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Sonya Khanna

Business Editor

 

According to the Conference Board of Canada, since the mid-1990’s income inequality in Canada has been rising at an alarming pace compared to the U.S.

The Board reported that Canada has had the fourth-largest increase in income inequality among its peers.

Although the United States currently stands as having the largest income gap between rich and poor, the gap in Canada continues to grow at a dishearteningly faster rate.

“High inequality both raises a moral question about fairness and can contribute to social tensions,” said Anne Golden, President and CEO of the Conference Board. “In Canada, the gap between the rich and poor has widened over two decades, especially compared to our peer countries.”

Canada was one of the ten out of seventeen peer countries to display growth in income inequality between the mid-1990s to the late-2000s. Income inequality remained steady in Japan and Norway, and declined in the remaining five countries.

Although Sweden, Finland and Denmark displayed the largest growth in income inequality during this time period, these countries are considered to have relatively low inequality.

The Gini index, which is a globally recognized and commonly used tool for measuring income disparities, rose in Canada from 0.293 in the mid 1990s, to 0.320 in the late 2000s.

A Gini index of 0 indicates equal distribution of income in a particular economy, while 1 would indicate that one person has all of the income. The Gini index rose from 0.361 to 0.378 in the U.S. during the same period.

To assess whether global income disparity has increased, the Conference Board analyzed the income gap between rich and poor countries, the overall world Gini index measure and income inequality within all countries. Global inequality grew through the later decades of the twentieth century and into the early-2000s.

According to the Board, 22 per cent of people live in countries where the income inequality level is stable, while 71 per cent experience increasing inequality in their country.

Countries with highest inequality are generally clustered in South America and southern Africa.

On paper, the average Canadian is better off than in years past. Average income in 1976 was $51,000, with a 17 per cent increase to $59,700 by 2009, adjusted for inflation. Although these are optimistic figures, average income taken at face value is not necessarily an optimal measure of how the majority of the population is doing.

Some analysts place greater importance on using the median income of individuals to determine true income disparities.

The gap between the medium and average income has been growing in Canada, suggesting that incoming growth is distributed unequally.

While soft viagra the richest Canadians have increased their share of the national income, both the poorest and the middle-income Canadians lost share. The growth in the share of income distributed to the rich is due to growth in the demand for highly skilled labour and the loss of demand for low-skilled industries because of gains in more heavily skills-intensive exports.

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