to transform our city
Every elementary and secondaryschool in Hamilton should have abreakfast program. The ﬁrst and mostimmediate priority is to establish abreakfast program in every school inthe pre-amalgamated City of Hamilton,particularly the lower city. Theprovince currently funds just 15 percent of the cost of existing studentnutrition programs.
Make healthy choicesthe easy choices. To quotea popular dictum in public health:“The choices we make are shapedby the choices we have.”
Make physical ﬁtness andphysical education mandatoryfor each year of elementaryand secondary school.
Implement a voucher programfor low-income residents toobtain fruits and vegetables from thecity’s farmers’ markets. While thereis a stigma for people who have tohand over vouchers to a merchant,it’s less stigmatizing than a visitto the food bank.
Plant more trees inlow-income neighbourhoods.Did you know the City of Hamiltonhas a free tree request programthat can be completed online?For information, send an email email@example.com. The citycould help increase awareness of thetree-planting program in low-incomeneighbourhoods. Trees are one smallway of helping increase property valuesand neighbourhood pride.
It should be mandatorythat every person in Hamiltonis provided access to a family physician.When a person shows up in theemergency department and reportsno family physician, set up a programthat matches those peoplewith a family doctor.
Undertake a scientiﬁc studythat examines the dierencesin health outcomes and costs betweenthose people in the lower central citywho don’t have a family physician andthose who do. Identify the factors thatcause people to either not have — ornot visit — a family physician.
For family doctorsin the capitation model(where payment is on a fee-per-patientbasis rather than fee-per-service),compensation should be increasedfor patients who are elderly, or havemental health issues, or those withcomplex medical conditions.
Ontario’s capitation modelof physician remunerationshould set a required base percentageof patients on the doctor’s roster whoare elderly, or have mental healthissues, or have complex medicalconditions. This would help eliminatethe cherry-picking of healthy patientsby a practice.
Parking fees should bereduced at hospitals. A visitlonger than two hours triggers the $15maximum at Hamilton Health Sciences’McMaster site and a visit longer than2½ hours means a $20 fee at St. Joseph’s hospital on Charlton Avenue.At Toronto’s Hospital for Sick Children,a visit longer than 2½ hours costs anoutrageous $30.
Make it easier for children inlow-income neighbourhoodsto participate in after-school programs.
Provide incentives to young,pregnant, at-risk mothers toencourage them to show up for regularprenatal visits to help reduceHamilton’s rate of poor pregnancyoutcomes. The incentives could bedirect, in the form of ﬁnancial compen-sation, or indirect, in the form of merchandise and food vouchers. Thecosts are meagre compared to thelifetime cost of poor pregnancyoutcomes to the health-care andeducation systems.
Increase funding for thechild-care subsidy program.The city’s waiting list has skyrocketedto more than 1,500 by September fromaround 1,000 in March.
Move aggressively to cut therate of births to teenmothers through a targeted,co-ordinated approach that combinesthe eorts of public health, schoolboards and social agencies. Last year’sSpectator BORN series showed the rateof babies born to teen mothers in thelower central part of Hamilton wasabout 15 per cent, which is about fourtimes the provincial average.
Hamilton’s landmark Nurse-Family Partnership could beextended to all low-income ﬁrst-timemothers, regardless of age.
For high-risk cases, theNurse-Family Partnershipcould be extended to take in not justﬁrst-time mothers.
For high-risk cases, theNurse-Family Partnershipcould also be extended beyond thechild’s second birthday and run insteadto the start of kindergarten.
Improve the distribution of walk-in and after-hoursclinics in the lower inner city. Accordingto information from the OntarioMinistry of Health, there are no walk-inor after-hours medical clinics locatedbetween James Street and the Red HillValley Parkway in the east end.
Aggressively strive to cutthe smoking rate amongpregnant women. Smoking is a knownrisk factor for low-birthweight babiesand it’s well known that smoking ratesincrease as incomes decrease. AtHamilton’s Maternity Centre, whichhelps hundreds of at-risk andlow-income pregnant women each year, about one in four expectantmothers smokes.
The province must getserious about choking o the supply of cheap cigarettes that ﬂowfrom native reserves. Study after studyin country after country shows thesame thing: smoking rates are inverselyproportional to income. The higher theincome, the lower the smoking rate.
Before-school and after-schoolprograms should be available atevery school in the lower city, heavilysubsidized for the neediest parents.
Integrate day-care programs forpreschoolers with before-schooland after-school programs so parentsaren’t required to ﬁnd more than onelocation for their children’s care.
University and college bursariesand scholarships could be targetedspeciﬁcally at inner-city high schools.
Implement a mentoring programthat would match inner-city highschool students with successful adultsin the community. Those types of relationships could help provide thestudents with guidance, networking or just a shoulder to lean on.
Implement a twinning programthat would twin schools in thesuburbs with schools in the lower innercity. Cities twin with other cities all thetime, so why couldn’t schools inauent parts of the city twin withschools in less auent areas?
The minimum wage in Ontario —in Canada, for that matter —must be a living wage. A person working40 hours a week for 52 weeks at thecurrent Ontario minimum wage of $10.25 per hour would earn $21,320 forthe year, minus statutory deductions. InHamilton, a living wage has beencalculated to be $14.95 per hour. Thereare 30,000 people in Hamilton whowork yet still remain in poverty.
The City of Hamilton couldlead the way by paying a livingwage to all of its municipal employees.
Develop an evidence-basedsystem for setting socialassistance rates. Currently, 59,000Hamiltonians rely on either OntarioWorks or the Ontario DisabilitySupport Program as their main sourceof income and “most are living in deep,deep poverty,” said Tom Cooper,director of the Hamilton Roundtablefor Poverty Reduction.
Reduce class sizes in elementaryschools that have signiﬁcant ratesof children from low-income families.
The best teachers shouldbe placed in the poorest-performing schools.
The Hamilton Spectator