Interview on the Social and Structural Determinants of Health

The following is an excerpt from an interview between People’s Health Radio host Aiyanas Ormond and APH organizer Martha Roberts on the social versus the structural determinants of health.  Transcribed from the original interview done in the spring of 2011 on Co-op Radio.

Aiyanas:  What do we need to be healthy?

Martha: I think that’s an interesting question and we ask ourselves that at the APH on a daily basis, and really my answer to that question is another question:

What do you consider health?

This is one we’ve been exploring at the APH for the past five years because really I think there are a lot of ideas out there in the community about what is health.

If you look at the definition of health as the absence of disease or infirmity, then the answer to the question of “what do you need to be healthy?” would be a functioning body without any disease or discomfort, or pain; without any physical problems.  Of course, very few people actually define health this way, but we’re encouraged by the health messages we see to define health that way.  We need to be thin, we need to eat nutritious food, we need to get enough sleep at night. We need to do these things in order to have a functioning body.

We tend to look at it much more broadly.   If you look at the WHO definition of health, they say it’s a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.  So then you get more into the nitty gritty of what is the quality of people’s lives, are they satisfied, are they happy, do they have a place to live, do they have enough to eat? We start getting into deeper questions of in our lives do we have our needs met and are we fulfilled as human beings?  We tend to go this way at the Alliance for People’s Health

What do I need to be healthy? I need to have my basic needs met and I need to have something in my life that I do, or a place that I fit, where I’m welcomed and where I feel like I have fulfillment as a human being.

Aiyanas: Which brings me to the next question.  The Alliance for People’s Health makes a distinction between the social determinants of health, which is that idea of having your basic needs met, and the structural determinants of health.  Can you explain what that distinction is and why you think it’s important?

Martha: Our health care system is designed on the biomedical model, which is that first definition of health, that it’s the absence of disease or infirmity. Really if you look back through the history of medicine and the development of medical sciences you’ll see that it’s really founded on this reductionist principle that if there’s something wrong in our bodies and we’re unhealthy or we have a disease that it’s a matter of fixing a tube or a pipe or a chemical process that leads to a malfunction in our body in much the same way that we’d view our car.  If our car breaks down, if the tailpipe starts to smoke, if we hear a rattle, we take it to the auto mechanic, the mechanic puts it up on a lift, looks underneath, runs a few diagnostic tests, and says, “Ah ha, you need a new carburetor”, not that I know what a carburetor is, but it’s an example.  And so we buy a replacement part or we add some oil, or we add some kind of a chemical that makes the vehicle function better.

Well we’ve pretty much been able to say that’s too reductionist, human beings don’t function that way. So then the new fad, the new trend, is the social determinants of health.  New in the last I’d say three decades, really, spearheaded by the public health movement that says people aren’t just machines, that they’re actually influenced by their environment.  And so if we’re saying health is complete physical, mental and social well-being, what are those social determinants? So we say, well, if you look at people in the community, their biggest determinant, honestly, is economics; do they have money? Do they have money to access to have those things I mentioned before, the things that I need? I need a house, I need food, I need a job so I can pay my rent, I have to send my kids to school, I need childcare for when I’m working. So we say access to money and resources are the social determinants of health.  We need employment, we need housing, we need food, and we need education for ourselves and for our families.

If you look at the Ottawa Charter for Health or if you look at how the Canadian Government defines social determinants of health, we’ll see these things.  It also includes things like access to medical care.  We need to be able to see a physician or go to emergency if we break our arm.  We need these things in our lives in order to function as human beings in society.

Aiyanas: So those are the social determinants of health.

Martha: That’s the social determinants of health.

But really, you dig a little bit deeper than that and say, that still doesn’t make the cut.  We have working class communities where all of their needs are met and they still lead significantly less healthy lives, by any way we counted, than their counterparts in upper and middle class communities. And we say, “Why is that”?  So we have to dig a little bit deeper.

Then you get into the work of someone like Richard Wilkinson who says there’s a social gradient, and people are unhealthy along that social gradient.  At the APH we call that class.   Everyone has a social location in the economy and where that social location is, according to the role they play in society, determines whether they’re going to be healthy or not.

That leads us to a third point. So if we say it’s not just the social determinants of health and it’s not just your social location, then we get into what Vicente Navarro calls the structural determinants of health.  And that’s really the root of our analysis at the Alliance for People’s Health. It’s not just having access to those resources, but actually having control over those resources, that fundamentally makes the difference in people’s health.

So you can give someone food at a food bank, or you can have someone actually possess enough money to go to the grocery store and go shopping and choose their own foods. And you can guess who’s going to be healthier at the end of the day.  It’s the person who has the ability, the money, the control in their lives to decide what they’re going to eat, that actually has better nutrition, and not just nutrition, but sense of self, sense of well-being, sense of control over their lives.

At the APH we say ultimately what we need to be looking at are the structural determinants of health. That’s power in our society to make decisions, not just over your own life, but over the whole functioning of your community, and the control over the resources that you need to make the changes that need to be addressed.  That’s why we see the social gradient. It’s not just happenstance that working class communities suffer less health, they suffer less health because they rely on state services and charity and have to struggle for the things that they need, whereas people in the upper classes have the things they need taken for granted.

Aiyanas: So what’s the strategy at the Alliance for People’s Health for challenging that?  And especially considering that it’s more than just a health gap that’s associated with the wealth gap, but it’s actually about power and control over our communities and our society.  What’s the APH approach in terms of a strategy?

Martha: I think we have two approaches.

One is that we don’t say that the social determinants of health aren’t worth looking at.  We do agree, yes, there is definitely something to the social determinants of health. We start with that.  We have community health projects where we say, you know what, if we need food or we need information about something, we need to know how we can get into social housing, we need to have basic health education about how to take care of ourselves and our families, where to access resources; let’s start with this.  We have community health projects, where as health workers, because many of us are health workers, though some of us are community health organizers and community members passionate about health, let’s spread the knowledge around!  Let’s get together as a community and ask how can we get the things that we need and how can we take care of ourselves?  How can we address the question of the basic needs?

And then the second thing is to actually get involved from there in making changes.  And there are two kinds of changes we want to make at the APH.  There are the changes that demand more access to social services; the government needs to provide us more state services. We need to stop cutting social programs; we need to stop cutting back MSP-insured services. And simultaneously we need to start struggling as working class communities to expand social services again in the context of the expansion of budgets for business and the military.  We need to say these things are unacceptable and we need to struggle for social services.

We actually need to engage people in that struggle.  That for me, as an organizer, is the biggest thing we can do. If you remember back to my answer to the question, what do we need to be healthy, people need something in their lives where they feel they’re exhibiting control, and they have a meaning or a purpose. Being involved in the struggle for the health of your community through political campaigns and community health projects actually improves people’s sense of dignity, it improves their sense of self-worth, it provides them a community that’s supportive, and it improves their own sense of health and well-being.

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Contesting Neutrality Part II: What’s a Radical Health Worker To Do?

“Lincoln Hospital Belongs to the People”
From left to right: Dorothea Tillie, Cleo Silvers (seated), Pablo Guzman (seated), Juan Gonzalez (standing), Andrew Jackson (seated, face partially obscured); others unidentified. Collection of Hiram Maristany.
From Social Medicine Vol 2, No 2 (2007)

Monday October 29th
6:30: Movie ‘Diagnosing Poverty: Building Community’ and light meal
(optional)
7:00 – 9:00: Group discussion

Please RSVP if you plan to attend and for directions to the meeting location: allianceforpeopleshealth@gmail.com

In the context of roll-backs in public health services such as essential health care coverage for refugees, attacks against public sector workers, a crisis access to post-secondary education due to rising tuition costs, and the rapidly escalating cost of living, more than ever working class and marginalized communities struggle to make ends meet and still fall short of the basic requirements for health.  How can we achieve health for all when we’re spending all of our time filling in the gaps and healing the wounds inflicted by the injustice of capitalism?

Taking cue from those health workers standing up for refugee health, and drawing inspiration from students in Quebec, the APH invites you to participate in a discussion of what a progressive health movement looks like.  Who participates in this movement? Who leads it? What kind of organization would it take to fight back?  What are the demands that unite us? What is our vision of health for all?  Ultimately, we ask ourselves, as radical health workers, what can we do together to transform our system and to struggle long-term for social justice?

Recommended reading “Is Capitalism a Disease: The Crisis in US Health” by Richard Levins. If you only have time to read part of the article we recommend you focus on the section Responses to the Crisis on pages 18-23.  If you don’t have time to read any of the article, that’s OK! Please join us for the discussion!

At 6:30 we will show the 30 minute movie “Diagnosing Poverty: Building Community” about Community-Based Health Programs in the Philippines and share a light meal together.
At 7:00 we will begin our discussion

Check out this article: Seize the Hospital to Serve the People and the video interview with Cleo Silvers who was active in the campaign to Seize the Hospital to Serve the People

MORE ON DIAGNOSING POVERTY: BUILDING COMMUNITY: “This is a story of Baby Jessie, a child from an indigenous community in Bukidnon, Philippines who almost died because of government neglect and wrong priorities. A story of ordinary people’s courage to organize and mobilize themselves to overcome poverty and build a healthy society. Produced in cooperation with Intal. Diagnosing Poverty, Building Community is an official selection to the New York International Filipino Film and Video Festival 2005.”

Cuts to Interim Federal Health, Forced Migration, and Imperialist Globalization

This talk was given by APH organizer Martha Roberts at this recent event organized by No One Is Illegal

Greetings from the Alliance for People’s Health.  I’d like to start by applauding No One Is Illegal for hosting this timely round table and raising the level of the conversation on migration and repression.  I’d like to thank you for asking me to speak today to share our perspective on the cuts to interim federal health and the consequences of imperialism on the people’s health.

1.      Impacts on Health

I work as a Registered Midwife in Vancouver providing prenatal, intra-partum, and postpartum care to new moms and babies until 6 weeks of age.  In plain language, I look after pregnant mamas and deliver babies.

Following the cuts to the IFHP prenatal care coverage for refugees will depend on if their country of origin is listed as a Designated Country of Origin (DCO); the list of DCOs is not yet public.  Prenatal care for women not from DCOs will continue to be covered.  If they are from a DCO (European countries, some speculation re: Mexico and Latin America) prenatal, intra-partum, and postpartum care will not be covered.  Medications will not be covered to any refugee, unless the diagnosed health condition poses a risk to Canadians.  Pregnant women suffering from gestational diabetes, preeclampsia, hypo or hyper-thyroid, or other serious disorders of pregnancy will not have coverage for their medications[i].

On February 27, 2012, the CBC ran a story “Mom without medicare gives birth in hotel: Immigration backlog left pregnant wife of Canadian without status”[ii].  This story caused a flurry of discussion amongst midwives and maternity care providers about caring for women without medical insurance, the potential risks involved for moms and babies, and the high possibility of poor outcomes which have a devastating impact on both care providers and parents.   Women who must self-pay for prenatal care book late into care, are far more likely to decline screening and diagnostic tests, and are forced to balance financial risk with risk of undiagnosed and untreated complications for themselves and their babies.  The mom in the CBC story was a healthy white woman of Scottish descent from a relatively privileged background; what of those whose stories aren`t told?  We know as maternity care providers and in my personal experience as a midwife, working class, marginalized, and racialized women experience poorer birth outcomes, including but not limited to higher rates of hypertension, premature birth, and low birth weight babies.  It is only a matter of time before the impacts of these cuts begin to be realized on a generation of babies born without proper health care.

The cuts to Interim Federal Health are reinforcing and expanding a three-tiered system of health care in Canada.  The first tier is those who can afford privately funded supplemental care over and above what is provided by MSP; the second tier is those who are limited to what the public insurance system will cover; the third tier is those who are denied access to public insurance and segregated as non-deserving; left to fend for themselves in a convoluted maze of bureaucracy, negotiating scraps of piecemeal care.  As immigration requirements continue to tighten, this third-tier will continue to expand.

2.      The Health Sector Response – Petty Bourgeois Politics

Actions from physicians, nurses, midwives, and medical students have been inspiring and at times courageous as they confront Minister Kenney and other Conservative Cabinet Ministers to demand a stop to the IFHP cuts.  As an anti-imperialist and international solidarity activist I am moved by the actions of the professional health sector, which historically has been predominantly a reactionary force.

As a true reflection of its petty bourgeois class position, the Society of Obstetricians and Gynecologists of Canada issued a statement on June 4th supporting the Conservative decision to cut the IFHP, recognizing that “spending from the public purse in support of health services is reaching crisis proportions” and that “products and services must be dispensed in a fair and equitable manner that is consistent with what Canadian tax payers are currently entitled to”[iii].

The majority of health professional associations are standing up in defense of refugee rights to access to health care, and I agree with the three basic tenants of their arguments:

1. Spending and budgetary constraints: that cuts will not be a cost savings but will off-load federal spending onto the provinces as more and more folks show up in emergency rooms and health conditions are exacerbated by lack of timely care;

2. Helpless and deserving recipients: that refugees deserve our help as Canadians; here I quote from the Huffington Post, “Dr. Mark Tyndall, a physician in Ottawa, says these “unfair and unethical” cuts would reflect poorly on Canada, by “taking the most disadvantaged and traumatized human beings on Earth and telling them we have been too generous for too long.””[iv]

3. Moral obligations under international law: references to Canadian obligations as a signatory on the Universal Declaration of Human Rights and the legal, moral obligations of states to provide equally for all.

I don’t dispute any one of these popular positions.  What troubles me as an anti-imperialist are the narrow confines of the discussion, reflecting the petty bourgeois class interests of the health professionals, which, unfortunately, based on my personal experiences of discussion in the community of midwives, can be boiled down to whether or not the health care provider gets paid for the work they do.

3.      The Right to Rebel – A Working Class Response

It’s time to blow up these three narrow positions and take a more comprehensive anti-imperialist approach to defending the rights of all migrants, whether refugee claimants, economic migrants, or undocumented workers.  As the health sector, it’s time to oppose war, occupation, and unjust trade as the roots of forced migration, and take a stand on the side not just of more obligations, but of justice.

The health sector needs an anti-capitalist approach.  Let’s broaden the discussion of budgetary constraint and spending and examine the entire federal budget.  Why are we trapped in a discussion of health care spending?  The federal government’s Canada Health Transfer is 29 billion for 2012-2013[v], while Department of National Defence spending has reached $22.5-billion[vi].  The projected cost savings through cuts to the Interim Federal Health Program over the next five years is $100 million or 20 million annually[vii].  And yet on June 8th the Canadian Armed Forces announced a 708.7 million dollar contract to purchase 500 Tactical Armoured Patrol Vehicles (TAPV)[viii].  Further, the Department of Energy and Natural Resources has committed millions in tax credits to support the expansion of the mining and extractive industries which plunder Third World and indigenous territories, and Export Development Canada continues to mitigate financial risk for overseas exploration.

If we’re to move beyond a losing reformist struggle we’ve got to move beyond the arguments of the capitalist states and advance our own positions.

The health sector must stand against national oppression.  It’s time for the health sector to drop the language of “deserving” and stand up against Canadian foreign and military policy; we’re culpable in forced migration.  Canada continues to sign trade agreements with Israel and support the Israeli apartheid.  Canada continues to expand ‘investment defense’; defending capitalist profits at the expense of oppressed nations and peoples.  As a NATO member, the Canadian military is responsible for oppressive occupations and imperialist wars of aggression: currently Canadian Forces are leading Operation Artemis in the Arabian Sea, Operation Attention in Afghanistan, and Operation Calumet in the Sinai Peninsula in Egypt as three examples[ix].  In the recent past Canadian Forces have engaged in operations in Haiti; Canada spent 347 million dollars and engaged in 733 bombing sorties above the North African nation of Libya[x]; and contributed to the training of repressive and murderous counter-insurgency forces in the Philippines.

Now is the time for the health sector to stand up for women`s rights and against patriarchy.   Migrant women have a long history of exploitation under Canadian temporary foreign worker programs.  It is women who will pick up the slack from cuts to health care insurance programs; it is women who bear the greatest economic burden of forced migration, and who bear the greatest burden of reproductive and caring labour.

I`d like to close by stating again that I applaud the professional associations and progressive health workers for standing up for the rights of migrants to access publicly insured health care in Canada.

Let’s build people’s institutions to care for those who lack access to public health insurance; democratic people’s institutions that address the structural as well as the social determinants of health!

Let’s stand in solidarity with the people’s legitimate right to self-defense and movements for national and social liberation!

At the Alliance for People`s Health we call on health workers to take that struggle one step further and hold the Canadian State accountable for the creation of unjust conditions which force migration, and for the exploitation of migrants in Canada.

Thank you

[i] Ontario Association of Midwives public policy analyst email communication, May, 2012

[ii] “Mom without medicare gives birth in hotel: Immigration backlog left pregnant wife of Canadian without status.” By Kathy Tomlinson, CBC News. Posted: Feb 27, 2012 6:58 AM ET: http://www.cbc.ca/news/canada/story/2012/02/24/bc-motelbaby.html

[iii] Society of Obstetricians and Gynecologists of Canada. 4 June, 2012. POSITION STATEMENT: Federal budget cuts to the Interim Federal Health Program.  http://www.sogc.org/documents/medRefugeeHealthBenefitsStatementENG120604.pdf

[iv] Ritika Goel and Naheed Dosani..  No Refuge for Refugees in Health Care.  Posted: 06/11/2012 12:03 pm. http://www.huffingtonpost.ca/ritika-goel/refugee-health-care-canada_b_1579385.html

[vii] Ritika Goel and Naheed Dosani..  No Refuge for Refugees in Health Care.  Posted: 06/11/2012 12:03 pm. http://www.huffingtonpost.ca/ritika-goel/refugee-health-care-canada_b_1579385.html

Social Determinants of Health: What is to be Done? An Open Study & Discussion with the Alliance for People`s Health

Monday May 21st 6:30 – 8:30 p.m.
Kiwassa Neighbourhood House @ 2425 Oxford Street, Vancouver
R.S.V.P. encouraged – email allianceforpeopleshealth@gmail.com

It has been 167 years since Frederich Engels published The Condition of the Working Class in England, identifying unjust social conditions as the leading cause of disease and injury amongst the English working class.  In 1978 delegates from over 120 countries to the International Conference on Primary Health Care in Alma Ata, USSR, re-affirmed the connection between social (in)justice and health.  In 2005 the World Health Organization struck the Commission on the Social Determinants of Health led by Sir Michael Marmot, a leading academic in the field of health inequities, and in 2008 this same commission published a `ground-breaking`report entitled “Closing the gap in a generation : health equity through action on the social determinants of health“.

Despite this sustained and growing interest in the connections between wealth inequities and health inequities, what is being done at the national and international level to address this connection?  What strategies are the WHO and other global institutions putting forward to address social justice?   What are some of the alternative strategies being adopted in countries where vibrant movements for social justice exist?  What can we learn from these movements? How is the health sector involved in such struggles?

Anne-Emanuelle Birn suggests in her article Making it Politic(al): Closing the Gap in a Generation: Health Equity through Action on the Social Determinants of Health that revolutionary redistribution of wealth and power is the way to address health inequities through concrete action towards social justice.

http://www.socialmedicine.info/index.php/socialmedicine/article/view/365/719

Join members and organizers of the Alliance for People`s Health for a study and discussion of Anne-Emanuelle Birn`s article and the contributions we can make locally through the Alliance for People`s Health.
We look forward to meeting you!

For more information, contact us at allianceforpeopleshealth@gmail.com

Women Be Brave, Stand on the Side of Justice!

Today as we rally to celebrate March 8th International Women’s Day, the Alliance for People’s Health salutes the brave and tireless leadership of women at the forefront of liberation movements struggling against US and Canadian-led imperialism across the globe.

Now more than ever it is urgent that we declare our opposition to imperialist globalization; that we decry capitalism as a corrupt and fundamentally unjust system.  It is imperative that we join the progressive forces of the world in commanding a serious consideration of socialism as a viable and a necessary solution.

As oppressed and exploited women, we know that economic exploitation and capitalist patriarchy underpins the crisis women face today.  Capitalism promotes patriarchal policies and practices, thriving on the cheap labour of women.  In Canada women comprise the vast majority of migrant workers from Asia, forced to migrate by neoliberal economic policies increasing the global wealth divide between the imperial north and the global south.  Canadian migrant women form a source of cheap labour, often providing privatized health care and modern-day domestic slavery to the Canadian middle and upper classes.  Migrant women in Canada face a double-burden of racist and profit-driven state and corporate practices designed to extract maximum profits from marginalized women.

Women’s reproductive labour continues to form the basis of capitalist profits. After a life-time of work in the home and raising children and caring for our families, the only compensation working class women receive for our labour are the occasional flowers and chocolates on Mother’s Day.  Are flowers and chocolate enough to compensate for a life-time of struggle?

On top of providing privatized labour in the home, women continue to be segregated into ‘women’s work’, teaching, nursing, preparing food, serving, and managing households.  Our work is devalued, and despite decades of struggle, women in Canada continue to be paid only 70% of what our male counterparts earn.

Our daily lived experiences speak to our economic situation under capitalism:

  • The majority of those who live in poverty in Canada are women and children: one in seven women in Canada lives under the poverty line.
  • Given our role as the providers of under and un-paid reproductive labour, women are far more reliant upon government services, and more deeply impacted by the escalating government cutbacks and slashing of public services such as health care, education, community-based services, childcare, and welfare.  Upwards of 60% of single mother families will be reliant upon welfare at some point.
  • Women are often segregated into public sector jobs such as teaching and nursing, and therefor face a double-impact of privatization and neoliberal globalization. As the conditions of our work continue to worsen, and our relative pay continues to drop, and our jobs are contracted out and privatized, we have fewer social services to fill the gaps.
  • And in the ultimate irony, as women we bear the greatest brunt of the health impacts of poverty, suffering from greater rates of many chronic and infectious diseases, depression, anxiety, and increasing social isolation.

As our daily lives are dominated by capitalism’s need for profits, our communities are increasingly being destroyed.  Environmental injustice abounds: from tar sands, oil pipelines, and mining projects that plunder indigenous territories, to the ever-escalating imperialist drive to wars of aggression, women are the most deeply impacted by imperialist globalization.

The Way Forward:   We are approaching a turning point in history.  As the global Occupy Movement has demonstrated, increasingly people are fed up with the fundamental injustices of capitalist economics!

We can no longer accept an unceasing drive for profits as the fundamental organizing principle of our society.  We must continue to speak out about the experiences of and consequences of capitalism in our lives, and yet we must start to take the necessary steps to build a viable solution to capitalism.

It is not enough to increase women’s access to jobs, higher wages, or pay equity with working class men – we must reject our exploitation as workers!

It is not enough to increase women’s access to capital through such NGO and finance schemes as micro-credit – we must reject our exploitation as producers!  There is no room for the private sector and patriarchal corporations in our future!

It is not enough to talk about policy change at the governmental level, as history shows us that what we fight for today, without concrete structural and fundamental economic change, we will be fighting for tomorrow – we must struggle towards a world beyond partial solutions!

It is time for women to rise up against imperialist wars of aggression, profiteering, and economic exploitation!

From Palestine, to the Philippines, to the unceded Coast Salish territory upon which we stand today, women are at the forefront of liberation struggles that ultimately seek to oust capitalism and replace it with collaboration, cooperation, and a society that values health, the fulfillment of human potential, and the survival of our planet.

Resources:

Alliance for People’s Health: https://aphvan.wordpress.com

International Women’s Alliance: http://internationalwomensalliance.wordpress.com/

International League of People’s Struggle – Canada: http://ilps-canada.ca/

Women’s Poverty in Canada: http://www.criaw-icref.ca/WomenAndPoverty

Asian rural women speak out: Rights, empowerment and liberation: http://iboninternational.org/resources/pages/EDM/67/162

BC nurses get involved with Smile With Dignity

With the escalating Smile With Dignity campaign, the demand for dental services to be covered under the BC Medical Services Plan (MSP) is attracting attention and supporters from across the province. In early December, the BC Nurses’ Union invited campaign organizers to participate in their Human Rights and Diversity conference. We presented our campaign at one of the conference sessions, inviting nurses to share their experiences with dental care in their practice. As nurses work on the frontlines of health care provision in our communities, they know firsthand the important role of oral health for overall health and wellbeing. Nurses spoke of the challenges of treating patients in longterm care with only sporadic access to a dentist. Others described patients with serious health complications that are made worse by lack of access to dental treatment. Even nurses themselves were affected by the inaccessibility of dental services. Janete Lois shared her story:

“I am a retired nurse. I am also a Diabetic. I need my teeth cleaned at least two times a year. Even with my extended coverage, I still have to pay $45.00 from my pocket to have my teeth cleansed!”

Nurses gave their support to the campaign by signing the Smile With Dignity petition and contributing personal dental stories or stories of their work. They are also helping to raise awareness of the campaign among their colleagues, patients, and networks in their home communities. As dental services and the MSP is a provincial issue, engaging with nurses and communities from across the province will ensure that voices and concerns from outside of Vancouver are also represented in our campaign.

Visit the Smile With Dignity website to learn more about the campaign and how to get involved.

Join the APH and the OC at Crafts for a Cause & Support Social Change!

The Organizing Centre will selling OC merchandise while attending this year’s Crafts For A Cause!

 

Crafts for a Cause: 4th Annual Craft Fair to Support Social Justice Struggles

Saturday December 3rd, 6-10pm
Rhizome Café, 317 East Broadway, Vancouver, Coast Salish Territories

Come shop for holiday gifts while supporting migrant rights, youth empowerment, Indigenous autonomy and more! Peruse socially conscious crafts by local artists, and items created by local organizations to support their social justice work. Food and drink will be available for purchase throughout the evening.  Participating artists and organizations include:

No One is Illegal: noii-van.resist.ca/
The Purple Thistle: http://www.purplethistle.ca/
Redwire Native Youth Media: http://www.redwiremag.com/
The Organizing Centre for Social and Economic Justice: http://organizingcentre.wordpress.com
Environmental Youth Alliance: http://www.eya.ca
Downtown Eastside Studio Society: http://studiosociety.ca/
Just Work Potters: http://www.justwork.ca/justpotters.html
Kalayaan Centre: http://www.kalayaancentre.net/

Plus:
Fair Trade Coffee from Cafe Justicia: cafejusticia.ca/
la mano ethical textiles: http://www.lamano.ca/
Prints by Favianna Rodriguez: favianna.com/
Rhizome Cafe T-Shirts and Buttons
Sam Bradd Designs: sambradd.com/
fierce green creations: etsy.com/shop/fiercegreen
Cease Wyss
Just Jingo Body Botanicals: http://justjingo.com/Just_Jingo/just_jingo_body_botanicals.html

Partial proceeds from artists’ sales are distributed to participating organizations.
$2 suggested donation at the door, but no one turned away
http://crafts4acause.wordpress.com; http://www.rhizomecafé.ca