Skip to main content
NCBI home page
Canadian Journal of Public Health = Revue Canadienne de Santé Publique logoLink to Canadian Journal of Public Health = Revue Canadienne de Santé Publique
. 2001 May 1;92(3):190–195. doi: 10.1007/BF03404303

How Government Policy Decisions Affect Seniors’ Quality of Life: Findings from a Participatory Policy Study Carried Out in Toronto, Canada

Dennis Raphael 17,✉, Ivan Brown 27, Toba Bryant 37, Judy Wheeler 37, Reg Herman 47, Jean Houston 47, Muhammad Hussain 47, Caroline Lanphier 47, Beryl Lightfoot 47, Beverly McClelland 47, Bob McIntosh 47, Irene Stevens 47, Frank Weisbeck 47
PMCID: PMC6979804  PMID: 11496628

Abstract

Toronto seniors explored how government policy decisions were influencing their health and well-being. In this participatory policy study, emphasis was upon the lay and critical knowledge of highly informed seniors. Focus groups and interviews revealed that all three levels of governments were seen as not listening to seniors’ voices. In nine key policy areas identified as influencing seniors’ quality of life–hearing seniors’ voices, housing, acute illness care, long-term care, income supports, transportation and mobility, promoting healthy lifestyles, access to information, and hearing voices from cultural communities–many concerns were raised. The gap between government rhetoric and government action on seniors’ issues merits public health attention.

Footnotes

Ms. Lightfoot was a founding member of the Seniors’ Coordinating Committee and passed away in 1999

References

  • 1.World Health Organization. Ottawa Charter for Health Promotion. Geneva: WHO; 1987. [Google Scholar]
  • 2.Kawachi I, Kennedy BO, Wilkinson R Eds. The Society and Population Health Reader. Volume I: Income Inequality and Health. New York: The New Press; 1999. [Google Scholar]
  • 3.Wilkinson RG. Unhealthy Societies: The Afflictions of Inequality. New York, NY: Routledge; 1996. [Google Scholar]
  • 4.Keating DP, Hertzman C. Developmental Health and the Wealth of Nations. New York: Guilford Press; 1999. [Google Scholar]
  • 5.Canadian Public Health Association. Health Impacts of Social and Economic Conditions: Implications for Public Policy. Ottawa: Author; 1997. [Google Scholar]
  • 6.Bryant T. Knowledge development in policy change and health promotion. Submitted for publication.
  • 7.Coburn D. Income inequality and health status: The role of neo-liberalism. Soc Sci Med. 2000;51:135–46. doi: 10.1016/S0277-9536(99)00445-1. [DOI] [PubMed] [Google Scholar]
  • 8.Pal LA. Beyond Policy Analysis. Toronto: Nelson; 1997. [Google Scholar]
  • 9.Sabatier PA. Policy change over a decade or more. In: Sabatier PA, Jenkins-Smith HC, editors. Policy Change and Learning: An Advocacy Coalition Approach. Boulder, CO: Westview Press; 1993. [Google Scholar]
  • 10.Hall PA. Policy paradigms, social learning, and the state: The case of economic policymaking in Britain. Comparative Politics. 1993;25(3):275–96. doi: 10.2307/422246. [DOI] [Google Scholar]
  • 11.Williams G, Popay J, Bissel P. Public health risks in the material world: Barriers to social movement in health. In: Gabe J, editor. Medicine, Health and Risk: Sociological Approaches. Oxford: Blackwell; 1995. [Google Scholar]
  • 12.Raphael D, Brown I, Wheeler J Eds. A City for All Ages: Fact or Fiction? Effects of Government Policy Decisions on Toronto Seniors’ Quality of Life. Toronto: Centre for Health Promotion, University of Toronto; 2000. [Google Scholar]
  • 13.Raphael D, Phillips S, Renwick R, Sehdev H. Government policies as a threat to public health: Findings from two community quality of life studies in Toronto. Can J Public Health. 2000;91:181–87. doi: 10.1007/BF03404267. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 14.Williams G, Popay J. Social science and the future of population health. In: Jones L, Sidell M, editors. The Challenge of Promoting Health. London, UK: The Open University; 1997. [Google Scholar]
  • 15.Sabatier PA. An advocacy coalition framework of policy change and the role of policy oriented learning therein. Policy Sciences. 1988;21:129–68. doi: 10.1007/BF00136406. [DOI] [Google Scholar]
  • 16.Hall PA. Policy paradigms, experts, and the state: The case of macroeconomic policy-making in Britain. In: Brooks S, Gagnon AG, editors. Social Scientists, Policy, and the State. New York: Praeger; 1990. [Google Scholar]
  • 17.Bryant T. Comprehensive Paper on the Role of Knowledge and Non-state Actors in Policy Change. Toronto: University of Toronto Faculty of Social Work; 1998. [Google Scholar]
  • 18.Park P. What is participatory research? A theoretical and methodological perspective. In: Park P, Brydon-Miller M, Hall B, Jackson T, editors. Voices of Change: Participatory Research in the United States and Canada. Toronto: Greenwood Publishing Group; 1993. [Google Scholar]
  • 19.Minkler M. Community Organizing and Community Building for Health. New Brunswick, NJ: Rutgers University Press; 1997. [Google Scholar]
  • 20.Raeburn J, Rootman I. People-Centred Health Promotion. New York: Wiley; 1997. [Google Scholar]
  • 21.PATH Project. Pathways to Building Healthy Communities in Eastern Nova Scotia: The Path Project Resource. Antigonish, NS: People Assessing Their Health; 1997. [Google Scholar]
  • 22.Blaxter M. Health and Lifestyles. London, UK: Routledge; 1990. [Google Scholar]
  • 23.Fay B. Critical Social Science: Liberation and its Limits. Ithaca: Cornell University Press; 1987. [Google Scholar]
  • 24.Travers KD. The social organization of nutritional inequities. Soc Sci Med. 1996;43:543–53. doi: 10.1016/0277-9536(95)00436-X. [DOI] [PubMed] [Google Scholar]
  • 25.McIntyre E, Travers K, Dayle J. Children’s feeding programs in Atlantic Canada. Can J Public Health. 1999;90:196–201. doi: 10.1007/BF03404506. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 26.Woodill G. Independent Living and Participation in Research: A Critical Analysis. Toronto: Centre for Independent Living in Toronto; 1992. [Google Scholar]
  • 27.Rispel L, Doherty J, Makiwane F, Webb N. Developing a plan for primary health care facilities in Soweto, South Africa. Part I. Health Policy and Planning. 1996;11:385–93. doi: 10.1093/heapol/11.4.385. [DOI] [PubMed] [Google Scholar]
  • 28.Ervin A. Collaborative and participatory research in urban social planning and restructuring: Anthropological experiences from a medium-sized Canadian city. Human Organization. 1996;55:324–33. doi: 10.17730/humo.55.3.c64308058877264u. [DOI] [Google Scholar]
  • 29.Bailey D, Koney M. An integrative framework for the evaluation of community-based consortia. Evaluation and Program Planning. 1995;18:245–52. doi: 10.1016/S0149-7189(95)00019-4. [DOI] [Google Scholar]
  • 30.Health Canada. Taking Action on Population Health: A Position Paper for Health Promotion and Programs Branch Staff. Ottawa: Health Canada; 1998. [Google Scholar]
  • 31.Quality of Life Web Site. Results from the Seniors’ Survey. 2000. [Google Scholar]
  • 32.Lincoln YS, Guba EG. Naturalistic Inquiry. Newbury Park, CA: Sage; 1985. [Google Scholar]
  • 33.Toronto Disaster Relief Committee. State of Emergency Declaration: An Urgent Call for Emergency Humanitarian Relief & Prevention Measures. Toronto: Author; 1998. [Google Scholar]
  • 34.Golden A. Taking Responsibility for Homelessness: An Action Plan for Toronto. Toronto: City of Toronto; 1999. [Google Scholar]
  • 35.Ontario Non-Profit Housing AssociationCooperative Housing Federation of Canada. Wher e’s Home? A Picture of Housing Needs in Ontario. Toronto: Author; 1998. [Google Scholar]
  • 36.Ontario Non-Profit Housing AssociationCooperative Housing Federation of Canada. Where’s Home? Part 2. Toronto: Author; 1998. [Google Scholar]
  • 37.Care Watch. Behind Closed Doors. Toronto: Author; 1999. [Google Scholar]
  • 38.Ontario Coalition of Seniors Citizen’s Organizations,others. When Seniors Don’t Matter: How Government Cuts are Undermining Health Care. Toronto: Authors; 1999. [Google Scholar]
  • 39.Canadian Pensioners Concerned. Health Core Values Statement. Toronto: Author; 1997. [Google Scholar]
  • 40.Toronto Seniors’ Task Force. Building a City for All Ages: The Final Report of the Toronto Seniors’ Task Force. Toronto: Author; 1999. [Google Scholar]
  • 41.National Council of Welfare. A Pension Primer: A Report by the National Council of Welfare. Ottawa: Author; 1999. [Google Scholar]
  • 42.Human Resources Development Canada. Canada’s Public Pensions — There For You. Ottawa: Author; 2000. [Google Scholar]
  • 43.Canadian Benefits Consulting Group. Fact-finder: The Pocket Guide to Federal and Provincial Benefits Legislation in Canada. Toronto: Author; 2000. [Google Scholar]
  • 44.Jackson A, Robinson D F B. The State of Working Canada, 2000. Ottawa: The Canadian Centre for Policy Alternatives. 2000. [Google Scholar]
  • 45.Ross DP, Scott KJ, Smith PJ. The Canadian Fact Book on Poverty. Ottawa: Canadian Council on Social Development; 2000. [Google Scholar]
  • 46.Transportation Action Now. The Court Decision on Wheel-Trans. Toronto: Author; 1999. [Google Scholar]
  • 47.Yalnizyan A. The Growing Gap: A Report on Growing Inequality Between the Rich and Poor in Canada. Toronto: Centre for Social Justice; 1998. [Google Scholar]
  • 48.Raphael D. From increasing poverty to societal disintegration: How economic inequality affects the health of individuals and communities. In: Armstrong H, Armstrong P, Coburn D, editors. Unhealthy Times: Political Economy of Health and Health Care in Canada. Toronto: Oxford University Press; 2001. pp. 223–46. [Google Scholar]
  • 49.Canadian Union of Public Employees. Who’s Pushing Privatization? Annual Report on Privatization. Ottawa: Author; 2000. [Google Scholar]
  • 50.Canadian Pensioners Concerned. Position Paper on Privatization in Health Care. Toronto: Author; 1998. [Google Scholar]
  • 51.Marmot MG, Wilkinson R Eds. Social Determinants of Health. Oxford: Oxford University Press; 1999. [Google Scholar]
  • 52.Wilkinson RG, Marmot M. Social Determinants of Health: The Solid Facts. Copenhagen: World Health Organization; 1998. [Google Scholar]
  • 53.Raphael D, Bryant T. Putting the population into population health. Can J Public Health. 2000;91:9–12. doi: 10.1007/BF03404245. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 54.Truman C, Mertens DM, Humphries B Eds. Research and Inequality. London, UK: UCL Press; 2000. [Google Scholar]
  • 55.De Koning K, Martin M Eds. Participatory Research in Health: Issues and Experiences. London, UK: Zed Books; 1996. [Google Scholar]
  • 56.Holland J, Blackburn J Eds. Whose Voice?: Participatory Research and Policy Change. Bath, UK: Bath Press; 1998. [Google Scholar]
  • 57.Smith SE, Willms DG, Johnson N Eds. Nurtured by Knowledge: Learning to Do Participatory Research. New York, NY: Apex Press; 1997. [Google Scholar]
  • 58.Davies J, Macdonald G Eds. Quality, Evidence, and Effectiveness in Health Promotion: Striving for Certainties. London, UK: Routledge; 1998. [Google Scholar]
  • 59.Hancock T, Minkler M. Community health assessment or healthy community assessment: Whose community? Whose health? Whose assessment? In: Minkler M, editor. Community Organizing and Community Building for Health. New Brunswick, NJ: Rutgers University Press; 1997. pp. 139–56. [Google Scholar]
  • 60.Fischer F. Citizen participation and the democratization of policy expertise: From theoretical inquiry to practical cases. Policy Sciences. 1993;26:165–87. doi: 10.1007/BF00999715. [DOI] [Google Scholar]
  • 61.United Way of Greater Toronto. Toronto at a Turning Point: Demographic, Economic, and Social Trends in Toronto. Toronto: Author; 1999. [Google Scholar]
  • 62.Daniels N. Am I My Parents’ Keeper?: An Essay on Justice Between the Young and the Old. New York: Oxford University Press; 1988. [Google Scholar]
  • 63.Jeffrey B. Hard Right Turn: The New Face of Neo-conservatism in Canada. Toronto: HarperCollins; 1998. [Google Scholar]
  • 64.Raphael D. Health effects of New Right policies. Policy Options. 2000;21(8):57–58. [Google Scholar]
  • 65.Raphael D. Health effects of economic inequality. Can Rev Social Policy. 1999;44:25–40. [Google Scholar]
  • 66.Robertson A. Health promotion and the common good: Theoretical considerations. Critical Public Health. 1999;9(2):117–33. doi: 10.1080/09581599908402925. [DOI] [Google Scholar]
  • 67.Bartley M, Blane D, Montgomery S. Health and the life course: Why safety nets matter. Br Med J. 1997;314:1194–96. doi: 10.1136/bmj.314.7088.1194. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 68.Kawachi I, Kennedy BP. Socioeconomic determinants of health: Health and social cohesion, why care about income inequality. Br Med J. 1997;314:1037–45. doi: 10.1136/bmj.314.7086.1037. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 69.Daniels N, Kennedy B, Kawachi I. Justice is good for our health: How greater economic equality would promote public health. Boston Review. 2000;25(1):4–21. [Google Scholar]
  • 70.United Nations. United Nations Principles for Older Persons. New York: Author. On-line at; 1999. [Google Scholar]
  • 71.Federal / Provincial / Territorial Ministers Responsible for Seniors. Principles of the National Framework on Aging. Ottawa: Authors; 1999. [Google Scholar]
  • 72.Lessard R. Prevent, Cure, and Care: Challenges of an Ageing Society. Montreal: Direction de la Santé Publique; 2000. [Google Scholar]

Articles from Canadian Journal of Public Health = Revue Canadienne de Santé Publique are provided here courtesy of Springer

RESOURCES