Student Corner - Winter 2010/2011

Slashing of the Special Diet Allowance

 

The Special Diet Allowance has granted money to individuals on social assistance in Ontario since 1998 to buy healthy food if they have a chronic condition. This service was essential because welfare amounts from Ontario Works and Ontario Disability Support Program are not enough to buy healthy food as well as maintain other costs of living. However, according to the 2009 Auditor General of Ontario’s Annual Report, alleged abuse of the program by both health care professionals and users of the program occurred resulting in higher costs that the government could not maintain. Despite outcry from anti-poverty advocates such as Ontario Coalition Against Poverty and Health Providers Against Poverty, Ontario went through with the cut in May 2010.

These alleged abuses included over-reporting illnesses with the intention of getting more money from the program. However, this could be accounted for in a correlational study comparing the general Ontario public’s chronic disease burden with that of low SES individuals. This would establish that most poor people already have multiple chronic conditions due to their low socio-economic status. Over-reporting may not be as a result of the doctor or the patient lying, but of the social conditions that force people into poverty in the first place.

A human rights approach to this issue is useful from a theoretical point of view. All people deserve the right to receive adequate nutrition and the state should ensure that this right is equitably guaranteed. A human rights approach did not seem to sway the Ontario government’s decision to slash the allowance. Instead, looking at the issue from a Social Determinants of Health standpoint may be helpful in assessing the program. A socio-political framework may be more applicable and understandable for government officials. Economically speaking, keeping the Special Diet Allowance makes much more sense for the Ontario health-care budget in the long term.

Currently, the Ontario government is planning a review of the Special Diet Allowance and various social welfare programs to determine their efficacy and whether they are worth keeping. As of April 1, 2011, new guidelines will be put into place that will implement a pseudo-Special Diet Allowance but with further restrictions on eligibility. For instance, pre-diabetics will be unable to apply for the diet. Furthermore, HIV-positive individuals will only be eligible once they lose 5% of their body weight. Ontario is essentially allowing its poor to become sicker before it will intervene. This is contrary to any evidence-based public health approach that aims to prevent illness or poor health before it occurs; this is both inhumane and economically unsound.