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Professor Dean Robinson’s Seminar in Health Care Inequality travels to Montreal

Professor Dean Robinson’s Public Policy Seminar in Health and Health Care Inequality in the United States Incorporates Perspectives from our Northern Neighbor

In late January twelve students from political science, biology, psychology, and other majors boarded a bus for Montreal, Quebec for a series of meetings and presentations on health and health care inequality in the Canadian context.

Professor Robinson’s interdisciplinary capstone seminar for the Commonwealth Honors College invites students to work on a range of senior theses on health inequalities in the United States. Students are doing research that addresses this topic from many angles (e.g. the biology of stress and policy implications, Latina reproductive health care access, federal nutritional policy and health disparities). Essential to this seminar is the opportunity for students to consider policy, health systems and population health from a comparative perspective, and that is what the two-day trip provided.

On the first morning, Pierre Paul Tellier, MD of McGill University discussed Medicare in Canada from the physician and patient perspective. He explained how Canada provides universal healthcare under tight budgetary constraints. He also discussed health inequalities with respect to First Nations populations (who have poorer health outcomes across the board) and new efforts designed to address them. 


 

Assistant Professor Mireille Paquet of Concordia University delineated key differences in the Canadian and US political and policy contexts. Despite both countries having federal systems, Canada’s parliamentary model is different with respect to executive power (more) and party discipline (more). Public health and health care policy reflects a much more fragmented policy arena in the US context. 

After Professor Robinson gave a presentation at Concordia University on protest movements in the 1960s and improvements in the health of blacks in the United States, students toured the Pointe-Saint-Charles Community Clinic. Lead by retired political organizer John Bradley, students received a walking tour of the working class neighborhood of Point Saint Charles and learned about the origins of this very unique clinic. Residents of that neighborhood govern the clinic, which serves “citizens” not “patients.” That phrase captured a very different model of health care that went beyond service provision to incorporate community participation and political advocacy.

On the final day of the trip, students returned to McGill University for a presentation by Professor Daniel Weinstock on new policies in the Province regarding patient assisted suicide. Students also attended a lecture by Professor Antonia Maioni who offered an historical analysis of why, despite very similar opposition to universal health care, Canada established a Medicare system that covers the entire population, not just the elderly and disabled as our Medicare does in the United States.

The final stop was at the Department of Public Health and Social Services where physician and Professor at the Canadian Academy of Health Sciences, Marie-France Raynault, summarized work the Department was doing on housing as determinant of population health. Professor Raynault’s team demonstrated how poor housing was related to worse health outcomes; and their research informed a new program that will expand the stock of quality “social housing” (what we refer to as public housing in the US). Many students were struck by the fact that the Department of Public Health, in a major metropolitan city of over two million, would focus squarely on housing as a social determinant of health.

Students were effusive about the opportunity to visit Montreal. Political science major Julia Neilsen said that “it expanded her understanding of Canadian politics and health care vastly” and that “it will help a lot “with her thesis. Another political science major, Selena Santiago, found the trip to Canada “very enlightening” and was “impressed by the focus on social determinants” which is not common in the US context. Selena also noted that the health care system of Canada provides equal access, whereas the US has a system wherein medical costs get in the way of universal access. Biology major Anna Klouda was also surprised to see a focus on the social determinant of health, and reflected that Canada seemed “better equipped to help citizens reach their full potential, through policies like Medicare for all, affordable child care, education and housing and allowing community centers to advocate politically.” Political science majors had some familiarity with comparative politics, but this trip offered a crash course for all involved. 

Jillian Crehan (kinesiology/psychology) noted that she “knew little about the political parties in Canada, the parliamentary system, and the power held by the provinces." She came away with a fuller appreciation of how the “political environment influences differences in healthcare systems.” All the students highly commended the trip, enjoyed the comradery, and expressed hope that other students could benefit from the experience. Megan Hennessey (psychology) offered that she “would definitely recommend that other students get the opportunity to experience the trip because . . . experiential learning is definitely much more impactful [because it allows] the students to be immersed and integrate their prior knowledge."

 

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