Presentation to the City of Toronto Budget Committee
My name is Laura Hanson and I am a nursing policy analyst with the Registered Nurses’ Association of Ontario (RNAO). RNAO is the professional organization representing more than 30, 000 registered nurses who practice in all roles and sectors across Ontario. We appreciate the opportunity to participate in these public consultations.
As a Budget Committee, you are facing a choice. Will City Council apply creative remedies to the task of building a healthy city? Or will you impose restrictions and cuts that will negatively impact the well being of all of Toronto’s residents and will, within certain communities, have devastating consequences?
RNAO is speaking here today because nurses are acutely aware of the critical link between social and environmental conditions and health. We work in schools, hospitals, offices, shelters, long term care facilities, on the streets and in patients’ homes. Nurses hear and see the struggles that people, especially those on social assistance and in low-paying and precarious jobs, face to get basic necessities such as food, shelter, clothing, child care, recreation services and transportation.
We know that across-the-board cuts to city services will mean decreased health and well-being for all City residents. As nurses, we are especially concerned that those who are most vulnerable and already struggling will face a disproportionate burden due to these proposed cuts.
Take public transit as an example. Increasing fares and reducing service on the TTC will mean older people, families with young children, youth, and adults living on low incomes will have great difficulty getting to health care appointments and health promotion programs. People depend on public transportation to travel to work and school, both key determinants of health, so the painful combination of reduced services and increased fares will cause much hardship. If more people decide to use cars as a result of a less functional public transit system, more air pollution will threaten our respiratory health, our children will suffer ever-more acute asthma, and all of us will experience greater stress in daily commuter gridlock. Service reductions in the Wheel Trans program will mean that older people and people with disabilities will have more barriers to providing their valuable contributions to the community. This is not the picture of a healthy city.
Another example is user fees for recreational facilities and parks. As a community health nurse, I often work with families who have to spend 60 or 70 per cent of their monthly income on rent. Their small amount of remaining money is stretched as far as possible to cover food, clothing, medical supplies and transportation. Having to pay a service fee will put recreational facilities for these families well beyond reach. Recreational facilities and parks provide direct benefits from physical exercise, including better cardiovascular health, reduced risk of obesity and related chronic diseases such as diabetes, and decreased symptoms of depression and anxiety. However, other benefits include a safe place to relieve stress, socialize with neighbours and build community as well as a space for youth to learn to resolve disputes. Outdoor spaces such as Riverdale farm provide cool shade in the summer and a healthy connection with nature and animals. All of these touchstones of a healthy city will be put at risk by the proposed across-the-board cuts.
Finally, the proposal to close shelter and detox beds is extremely disturbing and a huge step in the wrong direction. Bellwoods House, Birchmont Residence and Downsview Dells provide enhanced support for homeless people with multifaceted health and social requirements. By removing these services, which are currently in great need of enhancement, we will see more people with high needs living in the general shelter system, underhoused, or on the streets, often victims of violence, struggling to perform personal care and manage their chronic diseases. Any additional strain on shelters and affordable housing in Toronto will reduce access to a fundamental determinant of health: safe, adequate housing.
Nurses join with many other Torontonians in urging you to act wisely and with courage to ensure that everyone in our city can live in health and dignity. Instead of talking about “taxpayers’ rights,” we need to talk about our common rights and responsibilities as people living together in this great city. We need a progressive tax system and a revitalized way of thinking about revenue sources such as those identified by the Wellesley Institute in their Countdown to Zero: Balancing Toronto’s Budget document. Let us work together to take care of those in need, work together to build more vibrant neighbourhoods, and together leave a healthier city for generations to come.