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The deteriorating health of the working poor


Last year the Metcalf Foundation released a report on working poverty in Toronto. It found that 113,000 people were living in working poverty in the Toronto region in 2005, a 42% increase from 2000. The report's findings indicate that people living in working poverty most commonly work in sales and service occupations; work comparable hours and weeks as the rest of the working population; are over-represented by immigrants; and are only slightly less-educated than the rest of the working age population.

That report raised questions for us on the impact that working and living in poverty has on health. How healthy are people who are working but still can’t make ends meet? How does their health compare to those who are working and have sufficient incomes? How do both of those health outcomes compare to those who are poor and not working?

In our report Rising Inequality, Declining Health, we used data from the Survey of Labour and Income Dynamics, and the Metcalf definition of working poverty to answer these questions. These data show that those who are working but still live in poverty have worse health than those who are working and make sufficient incomes. In 2009, 53% of the working poor in Canada rated their health as excellent or very good, compared to 67% of those who had sufficient incomes. Similarly, 16% of people who were working and still poor rated their health as fair or poor compared to 7% of those who were not.

The health of those who have sufficient income has remained fairly stable between 1996 and 2009. However, the health of the working poor has deteriorated. Nationally, the share with excellent or very good health has dropped from 64% to 53%. During that same time the share with fair or poor health increased, from 9% to 16%.

These data demonstrate the relationship between work, income, and health. Those with higher incomes, more secure employment, and better working conditions have better health. This is consistent with the evidence on work and health, which clearly shows a relationship between working conditions, labour income, and health outcomes. Canadian evidence also shows a link between unstable working conditions or precarious work and health. 

The data in this report show a widening gap between the health of people who are living in poverty and working and those whose work provides sufficient income. This gap suggests that worsening labour market conditions, a weakened social safety net and increasing income inequality are accompanied by rising inequities in health.

Governments can take action to address this widening gap in Canadians' health. Updating the rules governing the labour market is a great first step; start with increasing minimum wages and strengthening enforcement to make sure workers get the money they have earned. Updating the law to make sure that it meets the changing needs of the labour market is the next step.

The lives and health of those in working poverty would be further enhanced by greater access to unionization through modernizing labour relations acts. Finally, we need to rebuild our social safety net, enhancing access to Employment Insurance and other social programs.

Canadians pride themselves on our universal access to Medicare. The deteriorating health outcomes for those who are working and living in poverty suggest that we need to do more to ensure equal access to good health as well as to health care.

Sheila Block is the Director, Economic Analysis at the Wellesley Institute. Her latest work, Rising Inequality, Declining Health, was published by the Wellesley Institute in July.

Photo: theseanster93. Used under a Creative Commons BY-SA 2.0 licence.