How ideology, apathy and anti-expert bias cut three years off Sask. lives

Health | Gregory Beatty

Life expectancy isn’t a perfect metric for measuring human health. But it is a decent stand-in, and for the last two centuries — thanks to advances in medical science, food production and nutrition, disease prevention and more — life expectancy has risen dramatically from under 40 in the early 1800s to 60 in the 1920s to, in Canada’s case, 82.23 years in 2019.

It’s now taken as a given that, as we continue to progress as a society, people will lead longer, healthier lives.

That’s why it was such a shock when Stats Canada released data this past fall from 2021 that showed life expectancy had actually dropped from 82.23 (2019) to 81.87 years in 2021.

Among provinces, Saskatchewan suffered a particularly sharp drop: 80.24 to 78.48 years.

Crunch those numbers further, and Saskatchewan’s life expectancy is well below the Canadian average — 1.99 years shorter in 2019, growing to 3.39 years shorter in 2021.

Media reports attributed the country-wide decline to COVID (which broke out in March 2020) and the toxic drug crisis.

Simon Enoch, the Saskatchewan head of Canadian Centre for Policy Alternatives, says Saskatchewan’s problems go deeper than that.

“Every province has experienced a decline in life expectancy and you could lay it all on COVID,” says Enoch. “But I think there are lots of other public health areas where the Saskatchewan Party government has decided to put ideology above evidence-based policy.”

For Cheryl Camillo, a health policy analyst at Johnson-Shoyama Graduate School of Public Policy, Saskatchewan’s statistics are sobering.

“When life expectancy goes down, especially precipitously — which seems to be the case with Saskatchewan being at its lowest point since the 1990s — it does mean that people are less healthy,” she says.

Many factors contribute to health outcomes. Some are instantly obvious, such as wealth (or lack of), a secure home and quality education.

Others, such as mobility, food security and community supports, are more subtle.

Across the board, Camillo agrees with Enoch that the Saskatchewan government too often puts ideology ahead of sound policy.

“Frankly, I don’t think the government is interested in people’s health,” she says. “If you look at their plan for growth, first they had 20 goals for 2020, then 30 goals for 2030. But very little of that has to do with health.

“And when you listen to policy makers, what you don’t [hear] is them identifying health as a priority.”

Instead, the government reacts to problems when they flare up, Camillo says.

“There were the long wait times at Royal University Hospital in Saskatoon recently, where there were 80 people in the waiting room, including four patients with severe mental illness who couldn’t be admitted. The government will throw money toward health services, but that’s the extent to which they engage in health.”

Ideology Trumps Lives

You might have heard or even read (cough) that far-right populism is on the rise worldwide. When Enoch thinks back to the Sask. Party government’s first decade in power, the contrast with the current government under Scott Moe is striking. [see sidebar]

“I remember how Brad Wall used to say ‘The Sask. Party is not ideological. We’re pragmatic. We don’t care what the policy is, as long as it works.’ You can debate whether that was true, but it was a talking point of the party,” he says.

“But when it comes to public health under the Moe government, they seem to be allergic to policies that work — or at least those put forward by people who work in the field, whether that’s harm reduction, HIV transmission, even COVID, with Saskatchewan being one of the first governments to lift restrictions in July 2020. With public health, they’ve been much more ideological than pragmatic,” says Enoch.

The toxic drug crisis is a prime example.

Since 2019, overdose deaths in Saskatchewan have risen from 180 to 404 (2021), to a projected 484 in 2023. Then there are all the associated challenges that accompany substance abuse, such as poverty, houselessness and physical/mental illness — including, most recently, amputations from festering wounds caused by fentanyl cut with Xylazine.

The main government talking point here is how they are investing in treatment for addiction.

But treatment is only one part of the equation, says Camillo.

“[Treatment] could benefit those who have a roof over their heads, that have a family who can maybe chip in, or even bail them out economically, if they don’t work for awhile while they’re in treatment,” she says. “It’s just common sense that it would be easier for people who have resources behind them.”

But for people who don’t have those supports, harm reduction can be a lifeline. But budget after budget, the government has put ideology over lives, refusing to fund safe-consumption sites and other harm reduction services.

“The way to foster trust and improve public health requires interventions that conservatives see as handouts or enabling certain behaviours — especially their aversion to harm reduction, because they think it tacitly legitimizes addiction,” says Enoch.

In addition to life expectancy, Saskatchewan also trails the Canadian pack in HIV/AIDS diagnosis rates.

The numbers are SHOCKING.

While the national diagnosis rate is 3.8 cases per 100,000 people, Saskatchewan’s rate is 20.8 cases — a full five times higher! Since some of the spread is driven by injection drug use, harm reduction could help there, too.

It’s not just HIV/AIDS. Saskatchewan also leads the nation in other key health indicators including teen pregnancy, STIs (including syphilis, gonorrhea and Chlamydia) and domestic and sexual violence.

A pragmatic conservative government would recognize the need to invest in sex education to improve health outcomes. But hard-right conservatives these days are all about cuts to sex ed.

That’s exactly what Scott Moe’s government delivered last summer when it banned third-party presenters and materials from classrooms and let parents take their children out of sex ed.

“We’ve seen advocates for a robust policy for HIV and STIs speak out against the dismal state of sexual education in Saskatchewan,” says Enoch. “The fact we don’t have a comprehensive sex education policy has contributed to the situation we are in.

“There is a direct link between lack of education, not following public health advice and having negative public health outcomes,” he says.

Camillo’s assessment of the government is equally blunt.

“There is nothing where they evince an interest in serving those populations who might suffer disproportionately from high-risk pregnancies, or teen pregnancies, or sexually transmitted diseases,” she says. “There is no interest.”

Not only is the Sask. Party’s hard-right ideology shortening people’s life expectancy, it’s straining our ability to meet basic health and safety/security needs by running our emergency services (police, fire, EMTs and hospital/clinic workers) into the ground.

Consider the Saskatoon fire department, which announced in December that four out of five calls in 2023 were for toxic drug emergencies. That takes time, energy and resources away from the department’s primary mission, which is to fight fires and promote fire safety.

“The government being allergic to preventative measures that don’t fit with their ideology has resulted in overcrowded hospitals and burned-out emergency workers,” says Enoch. “The consequences of not actually addressing these problems are felt society-wide.”

Enoch says the same dynamic is in play in education, where the government — with its inherent hard-right suspicion of public education and support for private (mostly religious) schools — is embroiled in a bitter labour dispute with Saskatchewan teachers.

“If the working conditions are dismal, it doesn’t matter how much money you pay people,” says Enoch. “They are going to vote with their feet and either leave the profession or leave the province and go to a place where working conditions are much better.”

Shorter lives. Poorer health. The numbers show that the Sask. Party government’s approach isn’t working.

Unfortunately, with a so-called growth-agenda focused on business and industry, they’re not numbers the government is interested in these days.

They’ve made that crystal clear, says Camillo.

“I’ve been in the world of health care politics for a long time, and I’ve seen politicians act in good faith, and I’ve seen them pretend,” Camillo says. “But with this Sask. Party government, they don’t even try to pretend to reach some segments of our community.”

Sidebar

Meet The Miserables

Want another life-expectancy statistic shocker?

From 2019 to 2021, life expectancy in the United States plummeted from 79 years to just over 76 — the largest two-year decrease since the 1920s.

Like Canada, healthcare services in the U.S. are largely delivered at the state level. When you crunch those numbers, it’s Trump Republican states such as Mississippi (71.9), Louisiana (73.1), and Alabama (73.2) that consistently bring up the rear.

Just like Saskatchewan does in Canada.

That’s no coincidence, says health policy analyst Cheryl Camillo.

“I really think Trump is their model, and I do consider this a Trumpian government,” says Camillo.

“The way I would characterize this type of conservatism, and what the government conveys, is miserableness,” she says. “I think the most miserable person in the world is Donald Trump. Despite what he says is wealth and power, all you see is a scowl on his face, and him [whining] about something or lashing out at someone.

“The only time you see something that might look like a smile is if he’s smirking,” says Camillo.

“I see the same thing with the Moe government.”

Camillo says research shows what truly makes people happy. She says a ‘sense of gratitude’ is one finding.

“You never see that from Trump, there’s never a ‘thank you’,” says Camillo. “You never see it from the Moe government, either. There’s never a ‘thank you’ to the Canadian government for X, Y or Z — it’s ‘you haven’t given us A, B and C’.

“They’re miserable, and I think they model an angry, resentful approach to living. And I think that’s impacting on people’s health,” she says.

This ‘miserableness’ is also sowing the seeds of future declines in life expectancy, says policy analyst Simon Enoch.

“This kind of right-wing populism, that is immediately suspicious of knowledge, that assumes experts are trying to impose their values on people — it’s a thread that runs through the government’s reluctance to consider public health advice,” says Enoch. “There’s been a real erosion of trust, and the government has assisted in that, I think, by continually discounting expertise.”

Still, Camillo holds out hope the tide will eventually turn.

“I think people were pretty passive for a while and didn’t want to see what’s happening. But I think eyes are opening, and I think the latest poll numbers show that,” she says.

“People see their communities fracturing, and they want to support the right policies,” says Camillo. “Then if you have someone from the base flinging Trumpian insults, suddenly they have cancer and need health services.

“Those numbers, I think, could make the difference.”