Canadian Index of Wellbeing
University of Waterloo
Faculty of Health Waterloo, Ontario, CANADA
The myth that economic gains “trickle down” has been exposed.
Undeniably, there is a massive and growing gap between Canada’s GDP and the wellbeing of Canadians. While the economy recovered post-recession, living standards plummeted and has failed to recover. Little overall progress has been made on the environment. Fewer Canadians report having very good overall and mental health and people are sacrificing the things that often make life worthwhile: leisure, arts and culture, volunteering, and social connections.
We can do better. Reductions in the numbers of people living in poverty and our success in ensuring greater access to education demonstrate that sound public policy can enhance the wellbeing of Canadians. Recent commitments by the federal government to tackle climate change also promise to bring an array of positive benefits to current and future Canadians. So we do have the ability to raise Canadians’ wellbeing in meaningful ways.
Wellbeing at the heart of policy
To reverse worsening trends and to narrow the gap, we need to understand that wellbeing is a system of interconnected systems. If we place wellbeing rather than the problem at the centre of decision-making, we begin to see the possibilities for solutions that cut across those systems. Ultimately, if we place wellbeing at the heart of policy development, then comprehensive, innovative, evidence-based policy emerges that can benefit all Canadians in multiple ways.
This is an invitation to all levels of government and all stakeholders to engage in broader dialogue and collaboration across boundaries, across departments, and across sectors. Our country deserves no less.
Creating a vision for positive change
In the fall of 2016, the CIW invited 18 people with expertise in one or more of the eight domains to a workshop to reflect on potential policy directions that would enhance the wellbeing of all Canadians. They were asked to consider the findings in this report – not only in their own area of expertise, but in all domains – to identify connections among domains, and to propose strategies and policy directions that could address multiple challenges simultaneously.
A central theme that emerged from the discussions was inequality, not just in income, but in health, in access to community resources, and in opportunities for leisure and culture. In response, the group recommended policy directions that considered the impact on multiple domains of wellbeing – an innovative and integrated approach to policy that would create multiple benefits for Canadians and reaffirm their core values.
With respect to income inequality, the group identified two specific policy directions:
- a universal basic income and extension of benefits to low-income Canadians.
The group also put forth policy directions to tackle inequality in other, interconnected aspects of Canadians’ lives:
- build on the strength of the education domain and develop a Pan-Canadian education strategy;
- focus on an “upstream” approach to health;
- leverage the collaborative power of communities for social change;
- provide universal access to leisure and culture; and
- improve the collection of social and environmental data.
Provide a universal basic income as part of social assistance to reduce income inequality
Universal basic income
A universal basic income is, in essence, a government policy that guarantees a regular income to all Canadians to help them live a basic and dignified life. Beyond improving living standards, basic income can enhance an individual or a family’s ability to make choices that meet their needs. A basic income lifts many Canadians out of poverty and increases access to opportunity – in work, in health, and in community life. Canadians, especially those living with low incomes, would have greater access to, and choice of, opportunities to participate more fully in education, leisure, arts and culture, and community events – all of which also enhance health, community vitality and overall wellbeing.
A basic income can also alleviate time pressure, allowing more time with friends, and creating more time for other important areas of a person’s life like child care, eldercare, education, and volunteering. Among the broader social benefits it can provide, basic income can reduce poverty, stimulate economic growth, lower health care costs, improve education, and reduce gender inequality – and all with less bureaucracy.23
There is widespread support for the idea of a universal basic income among Canadians as well as across political lines, and the debate is now focused on how to implement such a strategy in a cost effective way. While several approaches have been suggested, they fall into two essential types: (1) a fixed amount given to every person regardless of income, assets, employment status, or need; and (2) a refundable tax credit where every person receives an amount geared to income – the poorest receive the maximum amount and the richest receive none. This approach is also referred to as a negative income tax, and while it is more complicated to implement, it is seen as less costly. It is also the approach that is garnering the greatest interest and support.24
While a universal basic income would ensure that fewer people slip into poverty, it must not be regarded as a panacea or a replacement for all social assistance programs. Rather, it is a policy to be woven into the existing social assistance fabric. Like other effective assistance programs, such as the Canada Child Benefit and Guaranteed Income Supplement that are lowering the poverty rate among children and seniors, a universal basic income fills gaps that persist and ensures that people ineligible for targeted funds do not fall through holes in the social safety net.25
Extension of benefits to low income Canadians
By integrating basic income into the existing system of assistance programs, it would fill gaps in support that inevitably emerge as a result of changes in broader economic and social circumstances. However, many such benefits are not currently available to low income Canadians. For example, as part-time and precarious work becomes more common, fewer Canadians have access to employment-based benefits that provide them with health and dental care, pensions, and other benefits. Those most at risk are women, single parents, Indigenous peoples, racialized groups, and people with disabilities. These inequalities challenge our Canadian values of equity and fairness for all. Extension of benefits to low income Canadians would help protect vulnerable people from the risks associated with the loss of those benefits.26
When Canadians cannot access a basic income and the benefits they need, their physical and mental health suffers; the risk of housing and food insecurity increases; participation in community, arts, culture and recreation declines; and stress is magnified. The effect on individual wellbeing cannot be overstated, nor should the impact on the community be underestimated.
Taken together, these two policy directions indicate that we must:
- introduce a universal basic income for all Canadians as part of the social assistance system; and
- further extend health and social benefits to low and modest income Canadians.
Adopt a Pan-Canadian education strategy
Education has shown the greatest progress over the years. Given its importance to so many other aspects of Canadians’ lives, it is an area that should be leveraged to realize a number of wellbeing goals. By building on the existing education infrastructure and maximizing the power of curricula, Canadians’ preparation for life, work, and their full participation in society can be enhanced.
The means to achieve these outcomes is a Pan-Canadian education strategy spanning from early years to later life, creating opportunities for formal education as well as life-long learning and skills development. The strategy would recognize and celebrate education as process throughout life that begins informally within the family, and then continually transitions through early childhood education, elementary and secondary school, various post-secondary educational opportunities, and ongoing adult learning.
The objective for the strategy is three-fold:
- Increase the availability and affordability of formal and informal learning opportunities at all levels of education;
- Enhance curricula to strengthen its links to wellbeing outcomes; and
- Reduce interprovincial barriers to both education and labour opportunities, allowing greater cross-country mobility for Canadians.
The strategy includes elements at all levels of education:
Early Childhood Education
Kindergarten to Grade 12
A necessary companion to this strategy is to increase availability and affordability of regulated centre-based child care at the national level. Child care provides important developmental benefits for pre-schoolers. It improves children’s wellbeing, contributes to future academic success, helps to create a foundation for lifelong learning, and makes learning outcomes more equitable. In addition, available child care supports gender equity by providing more opportunities to women to enter the labour force, reduces the risk of poverty, and importantly, reduces inequality.28 Therefore, child care resources should be considered as a broader component within a Pan-Canadian strategy on education that leads to greater wellbeing for all.
Education is a key determinant for health, living standards, participation in democracy and cultural activity. Positive impacts of education are also felt in the individual’s family – often for generations. Further, when schools become a community hub offering programs before and after school, undertaking community partnerships and hosting events, the positive effects are amplified in community belonging and vitality. Health, culture and recreation are also enhanced.
A Pan-Canadian dialogue regarding global competencies in schools is already occurring at the Council of Ministers of Education, which has produced framework with a set of “guiding principles for education policy and curriculum to support the development of quality early learning programs."29 By developing a national education strategy, we would facilitate progress towards many important wellbeing outcomes.
Focus on an “upstream” approach for health promotion
The places and conditions within which we live, learn, work, and play are the most important determinants of our health.30 In turn, our physical and mental health affects our ability to work, our ability to learn, to engage fully with our friends and in our communities. Regrettably, our current health care system was not designed to consider these factors. It focuses principally on acute care and a “downstream approach” to restore health once it has been lost. Conversely, an “upstream approach” could prevent illness, disease, and injury before they take hold.
Upstream thinking shifts the focus to the conditions and circumstances in which Canadians are living, and identifies those factors that contribute most to poor health. Once identified, health promotion and care decisions are made to minimize the impact of those factors before they affect people’s health. Among the most critical factors associated with poor health are living in poverty and limited access to education. By acting on the policy directions already mentioned – universal basic income and a Pan-Canadian education strategy – we take an important step towards upstream thinking for health promotion.
An upstream approach provides broader access to a range of community-based health and social supports and helps reduce pressure on the primary health care system. It provides Canadians with support in settings that are more convenient and accessible to them, such as their homes, community health centres, and their places of work and school. A community-based health model has many associated benefits that speak directly to the core values of Canadians. Canadians value more independence in their self-care, which provides a greater sense of comfort, control, and dignity; greater focus on health promotion and illness prevention; and consequently, better health outcomes.31 Ultimately, an upstream approach can reduce health inequities.
- adopt a proactive and preventative approach to health care that identifies and addresses social and economic factors contributing to poor health; and
- expand access by creating a comprehensive community-based network of health and social supports that enables people – especially those facing barriers to better health – to access its benefits where they live. Such a network would include better access to:
- health care alternatives, such as nurse practitioners, family health teams, nutritionists, and social workers, for a more holistic approach to health promotion and care – regardless of where people live, their income level, or life circumstances;
- supports and services for people in their homes and their communities, reducing the reliance on long-term care facilities;
- mental health services in various settings throughout the community; and
- supports for both formal care providers and informal, family caregivers to ensure the maintenance of their physical and mental health and to enhance their ability to participate fully in the community.
There is already some evidence that an upstream approach can be an effective, efficient, and affordable means of delivering health and social support. Community Health Centres (CHCs) across Canada partner with other agencies and with the community to fully integrate a wide range of health promotion and community development services. These services proactively help persons in need to overcome barriers to greater wellbeing attributable to social and economic factors like income levels, access to shelter/housing, education, language, and geographic location. While CHCs have been very successful in meeting the health needs of vulnerable populations and in managing complex and multiple health concerns, too few Canadians have access to them. Extending the CHC model and network would serve to shift the focus to upstream thinking for health promotion, reduce inequities, and improve overall wellbeing.
Leverage community resources through collaboration
Canadian communities are the primary settings to enhance our access to arts and recreation, nutritious food and affordable housing, accessible and affordable public transit, and to foster civic engagement. The wellbeing of citizens and communities can collectively be enhanced through innovative social planning and enhanced urban design that embraces sustainability,32 the provision of more built and natural public spaces, and the walk-ability of neighbourhoods. The path to realize these outcomes at the community level is by building collaboration and cooperation among stakeholders, to break down the silos between sectors, and to experiment with social innovation. By investing in and sharing resources, both human and physical, we are better positioned to achieve a shared vision of enhanced individual and community quality of life.
Collaboration and cooperation among community agencies and organizations is critical in leading to social change and helping build community vitality. To bring about such change, organizations must abandon operating in isolation, regardless of how laudable their goals might be, and work towards solving complex problems through collective impact – a process that “focuses on the relationships between organizations and the progress toward shared objectives.”33 Community-based organizations and agencies all share a common vision of wanting the highest quality of life for citizens and this vision can be the impetus for them to work more collaboratively. Working together, they achieve the social change they desire. Five conditions are necessary for organizations to achieve collective impact:
- common agenda – setting goals based on a shared vision;
- shared measurement – gathering and sharing the evidence necessary to monitor progress;
- mutually reinforcing activities – building on unique contributions of each organization;
- continuous communication – building trust, reinforcing motives, and assuring progress; and
- backbone support – creating and defining the leadership necessary to foster and maintain cooperation.34
Municipal governments must also play a role. By placing wellbeing at the heart of municipal policy and by providing political leadership, municipalities can support collaborative efforts to achieve community quality of life – something governments also aspire to, but frequently have difficulty achieving alone. At the same time, not-for-profits, voluntary groups, funders, and the private sector can advocate with municipal governments for programs and services and policy development that address their common agenda and ultimately enhance wellbeing in a number of domains simultaneously.
By embracing collaboration and leveraging local resources to enhance wellbeing, municipalities can:
- involve citizens and community organizations more fully in planning, developing, and sharing important assets like schools, libraries, and community centres; parks, trails, and bike lanes; open spaces for the arts and public meetings; and alternative land uses like urban agriculture;
- consider how the natural and built environment affects many aspects of wellbeing across all domains, and working towards the development of greener buildings, more walkable communities, mixed use neighbourhoods, and integrated spaces where residents can meet, plan, and play;
- provide affordable and accessible public transit as a pathway towards improved health, greater engagement in leisure and cultural opportunities, access to better food and employment, reduced greenhouse gas emissions, and more effective time use for improved work-life balance;
- ensure all citizens, regardless of social or economic status, have access to opportunities for decent work; secure food and housing; access to leisure, arts and culture; enriched civic engagement; and
- monitor progress towards wellbeing goals through the regular collection of community-based data to establish baseline evidence of local needs, to identify gaps in access to opportunities that support wellbeing, and to guide local policy and initiatives especially in support of marginalized groups that might be falling behind.
Provide universal access to leisure and culture
Everyone has the right to rest and leisure, including reasonable limitation of working hours and periodic holidays with pay.35
Our time spent in leisure and culture is often when our lives are most fulfilling, when we can really be ourselves with friends, family, and people in the community, and pursue activities and interests that enrich our quality of life. Participation in culture, leisure, and recreational activities not only enriches us personally, but collectively. It is inevitably social in nature – it brings us into regular contact with others who share similar interests and values. These connections help build social cohesion by creating stronger ties to the community, nurturing more trusting relationships, and fostering greater understanding of diverse groups within the community. Unfortunately, as more people struggle to make ends meet, face precarious work, and worry about their homes and families, leisure is often sacrificed.
Yet we know the time spent volunteering or participating in leisure, culture, and recreation is important to our physical and mental health, to our social ties, to our ability to learn and grow, and to our sense of belonging. Recreation is a powerful venue to integrate new Canadians or marginalized people. The public places where we frequently engage in leisure are where trust, reciprocity, and friendships grow. Spending more time with friends in activities we enjoy alleviates stress and the feeling of time crunch. Therefore, a more than 9% drop in the Leisure and Culture domain is of particular concern because it represents where our wellbeing can be boosted the most.
To help reverse the downward trend over the past 21 years, leisure should be regarded not just as a basic human right, but should be considered a public good. Leisure is not something to be bought and sold in the marketplace. It is a fundamental expression of who we are and should be accessible to everyone regardless of their circumstances. All Canadians should have equal opportunity to freely engage in leisure and culture as a fundamental means to enhance individual and community wellbeing.
Consequently, to reverse the decline in Leisure and Culture, governments need to:
- ensure public recreation programs, services, and facilities are accessible to everyone in the community by, for example, eliminating or subsidizing user fees for people in low income and broadening opportunities for marginalized groups;
- maintain and extend funding to upgrade parks, recreation, and arts infrastructure in our communities;
- enhance opportunities for children’s active and outdoor play;
- support the development of non-traditional cultural and recreational activities to celebrate diversity and foster social connections;
- expand the availability and accessibility of public built and natural open space to ensure new and redeveloped communities include an integrated network of spaces where citizen engagement, social interactions, and play can occur; and
- leverage community resources by supporting collaboration among community groups and public agencies that identify local needs and facilitate access to leisure and culture opportunities, especially for marginalized groups and new Canadians.
These policy directions align with A Framework for Recreation in Canada 2015: Pathways to Wellbeing36 developed by the Canadian Parks and Recreation Association and the Interprovincial Sport and Recreation Council, and subsequently endorsed by federal and provincial ministers responsible for sport, physical activity and recreation in Canada. The Framework envisions recreation as a pathway to individual and community wellbeing, as well as the wellbeing of natural and built environments. Amongst its goals, the Framework advocates for active living, greater inclusion and access to recreation, supportive environments that encourage participation and community building, and making connections between people and nature.
An indication that the federal government recognizes the importance of supporting leisure and culture for all Canadians is a recent announcement to ensure that funding is available to support the recreation and cultural infrastructure within Canadian communities. For example, the New Building Canada Fund, part of which has committed approximately $13 billion to support projects of national, regional, and local significance, was extended in April 2016 to include culture, recreation, and tourism infrastructure. In addition, beginning in May 2016, the Canada Cultural Spaces Fund began investing $162.8 billion for cultural infrastructure thereby improving the physical conditions necessary for artistic creativity and innovation, and ultimately, better access for all Canadians to performing, visual, and media arts, museums, galleries, and heritage displays. When such funds are made available, communities should embrace collaboration in order to bring multiple sectors together – and hence, stakeholders of different domains of wellbeing – and leverage the necessary resources which will lead to social change.
Improve social and environmental data collection
We are living in an era of “big data.” Wearable computers literally track our every step and breath. Credit card companies monitor every transaction and our cell phones use a satellite-based global positioning system to map our every move. Yet Canada and the provinces lack an integrated system of comprehensive social and environmental data that would provide a clearer picture of our wellbeing. Data should be collected across the country regularly, in a standardized format, and at a geographic scale that would allow us to monitor progress from the national to the local level in all domains of wellbeing.
Evidence-based decision-making is critical to ensure that policy development and implementation are guided by the most current and relevant indicators of wellbeing. That’s why we must place greater priority on the regular collection and publication of high quality, reliable data. Statistics Canada, Environment Canada, and other federal agencies do provide some excellent data sources. Unfortunately, there are few robust, multiyear, and fully accessible national data sets on a wide array of social and environmental aspects that affect our lives.
Without such data, our efforts to report on changes to quality of life in Canada are hampered. We therefore must:
- place greater priority on the regular collection of high quality, reliable social and environmental data to better inform decision-making and the development of new policy;
- ensure the continued availability and accessibility of reliable, valid, and timely data on all aspects of wellbeing;
- gather data from the national to the local level to ensure the monitoring of progress in wellbeing at all geographic scales and sufficient comparability; and
- further develop systems to integrate administrative data and national survey data to provide more comprehensive and robust data sources without increasing the number of surveys or the redundancy in information gathered.
Even if these recommendations are implemented, a major gap still exists in our understanding of the wellbeing of all Canadians. Specifically, comprehensive data are lacking concerning Canada’s Indigenous peoples. Many national surveys exclude persons living on reserves and in designated settlements within the provinces. They also frequently do not include the people living in Nunavut, Yukon, and the Northwest Territories. Consequently, their voices are rarely included in national profiles of Canadians. Given that Canada’s Indigenous peoples face severe challenges to their health, living standards, and opportunities for quality education, their lack of representation in our data – and hence, our understanding – is unacceptable.
Better data – and better understanding of it through ongoing relationship and trust building – would inform policy designed to improve wellbeing for all Canadians.
- Improve the coverage, quality, and availability data on the wellbeing of Indigenous peoples.
The CIW promotes constructive and informed dialogue that can lead to positive societal change. With the CIW, we can choose to stop and question the status quo and consider alternative ways to promote a higher quality of life for all Canadians.
The divergence in the CIW and GDP tells us emphatically that we have not been making the right investments in our people and in our communities — and we have not been doing it for a long time. It is time public policy focused more on the quality of our lives. By looking at the CIW findings through a policy lens and considering how change occurs within a complex system of interconnected domains, we can make better decisions about how to improve the quality of life for everyone. We can determine how the various levels of government, the private sector, the community, and non-profit sectors can work collaboratively on improving those areas where we have lost ground since 1994, while building on those areas that have improved during the same period. The inter-related nature of the CIW domains requires this level of cooperation to achieve the best outcomes for all Canadians. Doing so will guide the development and implementation of good public policy and will measure progress on what really matters to Canadians for years to come.