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.
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.
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.
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: Saad Ejaz
DeltaHacks, an event organized by the HackitMac, held their second annual student hackathon at McMaster University on Jan. 16 and 17. The event proceeded with great momentum as over 300 students across Ontario came together to hack for positive change.
Beginning on Saturday morning, teams from different disciplines worked together for 24 hours to create a hack for positive change. A number of professionals, including doctors and professors, assisted the student-led teams. Coding mentors were also present, and helped students apply their ideas.
The event was focused around encouraging students to build and hack for social change. This could include health and wellness, sustainability or education.
The event yielded a total of over 50 unique project submissions. The winning project was a healthcare initiative by “Hips Don’t Lie”, a team of three: Mushfiqur Rahman, Hassan Muhammad and Stephen Murray. The trio worked with a McMaster orthopediatrician to create a web-app that uses x-ray images to diagnose a physiological condition known as femoroacetabular impingement through image processing algorithms.
Mohamed Fouda, a member of HackitMac, explained that the initiative started with the intent of creating positive change. “Here at McMaster we have great attention to social impact … we have a society program, we have Engineers Without Borders, we have Doctors Without Borders … we thought, okay, our hackathon should focus on projects that have a meaning to them. So we tried to encourage students to not just build anything, but try to give a thought before building, for a problem your hack would be able to solve,” said Fouda.
Students were encouraged to continue refining and building their projects even after the competition. Melissa Lam, a second year mechatronics student and a member of HackitMac, stresses on the importance of trying new things. “You got to go out and try new things … you got to give it a try, you got to fail,” she said. “You got to see the road, and that’s what university is for, to go out and do new things.”
Fouda added that the group hopes to do more in the future. “In terms of our long term vision, we have hit our milestones but we are still far from [finished]. The reason why we have HackitMac and DeltaHacks is because we are trying to create this community of people here at Mac just building stuff. They are trying, they are failing, and then they are trying again and then they are failing again … And they keep learning from mistakes and keep building … collaborating between different faculties, backgrounds, they share knowledge, they innovate and they build and solve problems.”
The team at HackitMac and DeltaHacks has received a great response and support in their first two years. They hope to continue inspiring groups to take on new ideas and work towards positive change.
Photo Credit: Jin Lee
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Gregory Wygoni
The Silhouette
“Science” was dubbed the word of the year in 2013. And though this may an impressive achievement for the human race, especially considering that the runner ups were “snuffalgapus” and “bieberlicious”, one cannot commend ourselves too generously. We still have a long way to go.
For example, let us go on a short walk from MUSC to BSB. Once there, realize you are in the science sector: chemistry, biology, physics. But yet, there is a lingering feeling that something is missing, Geology? Perhaps, but I argue there is something else, something deeper.
These science students, McMaster’s finest in the most pragmatic of arts, will not have the science that allows all what they learned to become possible. It is the magic glue that holds things together. Okay, it isn’t mathematics, which is the basis for what I am arguing, but instead computer science. Software and hardware are behind every innovation. You want some nuclear magnetic resonance, read the software output. You like polymerase chain reaction, try automation. Computer science, and the principles that underlie it, lay the foundation for much of modern science. It is not a difficult concept to debate then that digital literacy has never been more important. It empowers you to make what you want, and have the necessary skills to contribute positively in your field.
Yet most science students - not even to speak of the humanities, social sciences, or health study students - lack programming skills. Even our math majors can barely string together a valid function.
What is worse, the computer science students who are learning how to code are doing it perfunctorily. They worry only about output, rather than the language. The current paradigm for computer science in university is not different for any other program, do what they want, do well, and don’t be creative in your approaches. Such terrible practices are then translated to industry.
These habits also permeate through the online learning of CodeAcademy and the like. They teach you the basic format and language constructs, and that is all. You complete the exercises, all in a daze, and then wonder what is next. It is like learning the alphabet and thinking you can write a book.
The fact of the matter is that most students don’t know how to program, and those that do only know it robotically. This author does not evade these categorizations. To know how to program well, to appreciate the beauty of a language, to use its syntactic sugar well, is an art. To have great test coverage, to be efficient and write simple code is an ever expanding hallway in your worst nightmare.
Is there a reason most students do not learn how to code? Yes, because they believe it to be hard. If this is any counterpoint, I was able to learn. Secondly, as to why students who do know how to code, code poorly, I can only proffer the argument of patience. The art is long, and time is short. Most students think once they learn the alphabet they can put together Brave New World, yet the same is not for “Hello World.” The only solution I offer is teach computer science early, teach it well with as many different ways as possible, and wait.
Good stuff is waiting behind our semicolons.
