What's Up in Family Medicine, ​May 2015

Family Doctors Can Help Treat Poverty

“Evidence shows us that low income is closely tied to poor health outcomes. Linking patients living in poverty to social supports can help them gain economic stability and improve their health beyond what can be accomplished through medical interventions alone.”

- Dr. Ritika Goel, Co-Chair, OCFP Poverty and Health Committee

and Family Physician, Inner City Family Health Team, Toronto

In Ontario 20 per cent of families live in poverty and many more struggle, living just above the poverty line, to make ends meet. Evidence shows that poverty is a significant risk factor for poor health, with a number of conditions and diseases – including cardiovascular disease, diabetes, mental illness and some cancers – occurring at significantly higher rates among patients living in poverty.

“To effectively care for our patients we need to treat the whole person, and this means recognizing and addressing the impact of financial hardship on a person’s health,” said Dr. Ritika Goel, Poverty and Health Committee Co-Chair and ​Family Physician, Inner City Family Health Team in Toronto. “As physicians we need to recognize the impact of chronic stress on our patients, and practical issues such as ability to purchase healthy foods, over the counter medications or devices. Talking with patients about available programs and resources, ensuring they know how to get the benefits they are eligible for is very important."
Physicians may be hesitant to talk with patients about their personal circumstances or the impact of financial problems on their lives because we are not sure what to do to help. We can do a great deal simply by asking patients if they have filed a tax return to ensure they are receiving all possible tax credits and social benefits. We can connect them with social or community workers who can help with linking to local resources and income support programs, or refer them to a drop-in agency where they can connect with a housing worker if they are homeless.

The OCFP has a number of resources available to help family physicians provide useful support to patients living in financial hardship. The Mainpro-C accredited Treating Poverty: A Workshop for Family Physicians is a great place to start. The workshop takes a three-step approach to assessing and alleviating a patients’ financial situation and its impact. Workshop participants develop a deeper understanding of ​income security systems and available resources and programs, and better understand some of the ethical quandaries that can arise when working with marginalized groups. The workshop also helps with practical tips of how to start a conversation.

"When we adopt a comprehensive community approach to caring for our patients we look to treat the socio-economic factors that are having a negative effect on their health and not just the symptoms or underlying disease,” said Goel.

The Treating Poverty workshop is presented across Ontario as part of the OCFP’s CME-on-the Road program. See the calendar or submit a request to host a session in your local community.

If You Want to Help Me, Prescribe Me Money

In this TEDx talk, Toronto family physician and Poverty and Health Committee Co-Chair Dr. Gary Bloch, reflects on his practice experience and suggests how family doctors can help make poverty treatable.

Upcoming Treating Poverty Workshops

Want to host a session?

If you are interesting in hosting a workshop in your workshops in your community, please complete our workshop request form.
Two valuable clinical tools available to family physicians are the popular Poverty: A Clinical Tool and Child Poverty - A Practical Tool for Primary Care. These can be used for guidance on screening, interventions and links to social and community services, including 211 Ontario. Many people are unaware of the depth of information available through 211 Ontario. This 3-digit phone and online service is offered in more than 100 languages and provides 24-hour access to local community, social, non-clinical health and related government services.

Development of the Treating Poverty workshop and clinical tools would not have been possible without the hard work of the OCFP’s Poverty and Health Committee. Since ​2011, the Poverty and Health Committee has been finding innovative and practical ways to support and educate physicians about the treatment of poverty. Upcoming projects include developing an online version of Poverty: A Clinical Tool; an early literacy program for families with young children; and a train-the-trainer program to foster and support local presenters across the province. Committee members also regularly make presentations to medical students and worked with the University of Toronto to incorporate the treatment of poverty into its medical school curriculum.

Do you know of resources, events and opportunities of interest to family docs?

We welcome your suggestions for inclusion on our Bulletin Board.
Please note that inclusion is at the discretion of the OCFP and does not indicate endorsement by the OCFP. Thank you!