As COVID-19 cases worldwide soar past the 2 million mark, every health leader is calling for the same three things: increased testing, contact tracing and quarantining of those who’ve been exposed. Alongside their clear necessity for reducing disease spread, these steps are critical to our ability to reopen the economy and keep it open once we do.
But one key question remains unanswered: Who is going to put this plan into action?
Costly errors were made in this administration’s response to COVID-19, but the U.S.’s underinvestment in public health dates back decades. And as Congress takes up a fourth stimulus package, strengthening our public health infrastructure — including the human infrastructure — should be a priority.
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Doing so would not only create hundreds of thousands of jobs at a time of unprecedented layoffs, it would vastly expand our capacity to contain this pandemic and prepare for the next. Thousands of new graduates are about to enter a bleak economy, adding to the millions who are newly unemployed. The time is right for making bold investments in the preventive health workforce.
So what would that look like? The solution is two-fold: First, get more people into public health jobs. Second, ensure they can afford to stay there.
To address the first, we should invest in a national cohort of health workers who can roll out each element of the national COVID-19 strategy — let’s call it the Preventive Health Corps. From helping those who are quarantined meet their basic needs to undertaking noninvasive contact tracing to facilitating widespread testing, the Preventive Health Corps would fill an urgent resource need while also providing a much-needed job stimulus. The corps could build on existing service job models, like AmeriCorps, while paying the prevailing wage and providing full benefits.
The costs would be not only reasonable but far outweighed by the benefits. Even if we scaled up to 500,000 corps members, their compensation would amount to just a tiny fraction of the total stimulus spending, while yielding dividends for years to come. Moreover, these costs would be offset initially by savings from reduced unemployment claims.
Further, while COVID-19 represents the most urgent need, even in the absence of a pandemic, the U.S. sees well over 100,000 preventable deaths each year. A dedicated and comprehensive preventive health workforce — including direct service providers, educators, policy analysts and others — could powerfully reduce these numbers. And we wouldn’t be starting from scratch — existing institutions could host corps members, increasing their capacity to deliver tried and tested services and education.
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To support the preventive health corps long-term, we should accelerate and simplify loan forgiveness. Although many people desire to pursue public service, around 70 percent of those graduating with a master’s in an appropriate field have student loan debt that averages around $75,000; for some, the balance is far higher. Many go into private-sector jobs to pay off debt. An accessible loan forgiveness program would incentivize more people with backgrounds in public health, law, social work, urban studies or health sciences to get preventive health-related jobs and commit to them as careers.
The existing Public Service Loan Forgiveness program, which erases federal student loan debt after 10 years of public service work, should in theory cover most preventive health jobs. In practice, however, just 1 percent of applicants to the program have had their loans forgiven, a consequence of complex paperwork requirements, strict rules about qualifying payments and confusion about eligibility.
Providing forgiveness on an annual basis — that is, forgiving 15 percent of an individual’s loan balance each year — would provide immediate benefits to those pursuing preventive health careers while building confidence that loan forgiveness is actually attainable, rather than a risky gamble.
Politicians have compared the current crisis to a war, with some going so far as to propose a health care worker draft. Yet mandatory service is no more the answer for recovery from this health crisis than it is for the military.
Tuition reimbursement, adequate pay and a clear pathway for career advancement have strengthened our armed forces. So too would providing equivalent benefits to frontline preventive health workers, whose success will be profoundly important to our health and safety as a nation.
COVID-19 may be the greatest health and economic crisis of our lifetimes, and it’s easy to feel overwhelmed by the challenge. But the solutions are known and within our reach. If we invest now in the building and sustaining a preventive health workforce, that action will begin saving lives immediately and its benefits will continue well into the future.
Jody Heymann, M.D., Ph.D. is a distinguished professor of public policy, health policy and management and medicine at UCLA and former dean of UCLA Fielding School of Public Health.
Aleta Sprague, J.D., is a senior legal analyst at the WORLD Policy Analysis Center.
OTTAWA – Canada’s unemployment rate held steady at 6.5 per cent last month as hiring remained weak across the economy.
Statistics Canada’s labour force survey on Friday said employment rose by a modest 15,000 jobs in October.
Business, building and support services saw the largest gain in employment.
Meanwhile, finance, insurance, real estate, rental and leasing experienced the largest decline.
Many economists see weakness in the job market continuing in the short term, before the Bank of Canada’s interest rate cuts spark a rebound in economic growth next year.
Despite ongoing softness in the labour market, however, strong wage growth has raged on in Canada. Average hourly wages in October grew 4.9 per cent from a year ago, reaching $35.76.
Friday’s report also shed some light on the financial health of households.
According to the agency, 28.8 per cent of Canadians aged 15 or older were living in a household that had difficulty meeting financial needs – like food and housing – in the previous four weeks.
That was down from 33.1 per cent in October 2023 and 35.5 per cent in October 2022, but still above the 20.4 per cent figure recorded in October 2020.
People living in a rented home were more likely to report difficulty meeting financial needs, with nearly four in 10 reporting that was the case.
That compares with just under a quarter of those living in an owned home by a household member.
Immigrants were also more likely to report facing financial strain last month, with about four out of 10 immigrants who landed in the last year doing so.
That compares with about three in 10 more established immigrants and one in four of people born in Canada.
This report by The Canadian Press was first published Nov. 8, 2024.
The Canadian Institute for Health Information says health-care spending in Canada is projected to reach a new high in 2024.
The annual report released Thursday says total health spending is expected to hit $372 billion, or $9,054 per Canadian.
CIHI’s national analysis predicts expenditures will rise by 5.7 per cent in 2024, compared to 4.5 per cent in 2023 and 1.7 per cent in 2022.
This year’s health spending is estimated to represent 12.4 per cent of Canada’s gross domestic product. Excluding two years of the pandemic, it would be the highest ratio in the country’s history.
While it’s not unusual for health expenditures to outpace economic growth, the report says this could be the case for the next several years due to Canada’s growing population and its aging demographic.
Canada’s per capita spending on health care in 2022 was among the highest in the world, but still less than countries such as the United States and Sweden.
The report notes that the Canadian dental and pharmacare plans could push health-care spending even further as more people who previously couldn’t afford these services start using them.
This report by The Canadian Press was first published Nov. 7, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
As Canadians wake up to news that Donald Trump will return to the White House, the president-elect’s protectionist stance is casting a spotlight on what effect his second term will have on Canada-U.S. economic ties.
Some Canadian business leaders have expressed worry over Trump’s promise to introduce a universal 10 per cent tariff on all American imports.
A Canadian Chamber of Commerce report released last month suggested those tariffs would shrink the Canadian economy, resulting in around $30 billion per year in economic costs.
More than 77 per cent of Canadian exports go to the U.S.
Canada’s manufacturing sector faces the biggest risk should Trump push forward on imposing broad tariffs, said Canadian Manufacturers and Exporters president and CEO Dennis Darby. He said the sector is the “most trade-exposed” within Canada.
“It’s in the U.S.’s best interest, it’s in our best interest, but most importantly for consumers across North America, that we’re able to trade goods, materials, ingredients, as we have under the trade agreements,” Darby said in an interview.
“It’s a more complex or complicated outcome than it would have been with the Democrats, but we’ve had to deal with this before and we’re going to do our best to deal with it again.”
American economists have also warned Trump’s plan could cause inflation and possibly a recession, which could have ripple effects in Canada.
It’s consumers who will ultimately feel the burden of any inflationary effect caused by broad tariffs, said Darby.
“A tariff tends to raise costs, and it ultimately raises prices, so that’s something that we have to be prepared for,” he said.
“It could tilt production mandates. A tariff makes goods more expensive, but on the same token, it also will make inputs for the U.S. more expensive.”
A report last month by TD economist Marc Ercolao said research shows a full-scale implementation of Trump’s tariff plan could lead to a near-five per cent reduction in Canadian export volumes to the U.S. by early-2027, relative to current baseline forecasts.
Retaliation by Canada would also increase costs for domestic producers, and push import volumes lower in the process.
“Slowing import activity mitigates some of the negative net trade impact on total GDP enough to avoid a technical recession, but still produces a period of extended stagnation through 2025 and 2026,” Ercolao said.
Since the Canada-United States-Mexico Agreement came into effect in 2020, trade between Canada and the U.S. has surged by 46 per cent, according to the Toronto Region Board of Trade.
With that deal is up for review in 2026, Canadian Chamber of Commerce president and CEO Candace Laing said the Canadian government “must collaborate effectively with the Trump administration to preserve and strengthen our bilateral economic partnership.”
“With an impressive $3.6 billion in daily trade, Canada and the United States are each other’s closest international partners. The secure and efficient flow of goods and people across our border … remains essential for the economies of both countries,” she said in a statement.
“By resisting tariffs and trade barriers that will only raise prices and hurt consumers in both countries, Canada and the United States can strengthen resilient cross-border supply chains that enhance our shared economic security.”
This report by The Canadian Press was first published Nov. 6, 2024.
