The Costs of Poverty in BC: Nurses’ Voices Matter! by Paddy Rodney RN

Registered nurses and nurse practitioners provide care for individuals, families and communities from all walks of life across British Columbia. Many of the people we encounter face complex health and social challenges—and such challenges are especially complex for those who live in poverty. The BC Office of the Canadian Centre for Policy Alternatives (CCPA) recently released a compelling report about “The Cost of Poverty in BC”.

The report—co-published by CCPA, the Public Health Association of BC, and the Social Planning and Research Council of BC—is presented in 10 parts, starting with an introduction that provides useful background and orientation and concluding with a summary and concrete recommendations for future action by our provincial and federal governments. The material covered in between includes:

  • up to date overview of the scope of poverty in BC;
  • easy-to-read explanation of how the economic costs of poverty in BC are being estimated (really useful for readers such as myself who have absolutely no economics background);
  • insightful review of the impact of poverty on health (showing how poverty increases health care costs overall and reduces impoverished people’s ability to access health care);
  • disturbing review of the impact on crime (e.g. how childhood poverty and low literacy increase crime);
  • big-picture analysis of the profound economic impacts of poverty on our society (lost productivity, reduced economic activity, and lost earnings);
  • disquieting analysis of the impacts on future generations (i.e. the costs our children and grandchildren will be left to carry);
  • and a tally of the total economic costs of poverty as well as the economic case for reducing poverty.

Throughout, I found the CCPA report to be well supported by relevant research. The researcher’s main message is effectively framed in the summary provided with the report:

This study finds that the costs of inaction are so large that they exceed the costs of poverty reduction. Poverty is consistently linked to poor health, lower literacy, poor school performance for children, more crime, and greater stress for family members. It is society as a whole that bears the costs of poverty, through higher public health care costs, increased policing and crime costs, lost productivity, and foregone economic activity (p. 5).

The action suggested in the CCPA report focuses on provincial and federal government responsibilities. Seven priority areas are targeted, ranging from improving the earnings and working conditions of those in the low-wage work force; to universal, publically funded child care; to enhanced community mental health, home support, prevention and health promotion services (see the full list on p. 40 of the report).

I realize that I am posting this blog at a time when many nurses are hopefully enjoying at least some holidays. However, I encourage you to download and read the CCPA report when you have the chance. Why? Because the costs of poverty are more than just economic and the responsibilities to address poverty are more than just governmental. The costs are personal, social and ethical. And the responsibilities ought to be addressed by professional associations from a wide range of public sectors--including education, social services, and health. As nurses we see, for example, single mothers who are having trouble accessing child care and safe housing. We see older adults with chronic illnesses living in their homes on minimal income and unable to afford the medications, equipment and health care services they require but have to pay for out of pocket. And we see people struggling with addictions as well as chronic physical and psychological pain coming to our emergency departments because they can find nowhere else to go.

The voices of registered nurses and nurse practitioners throughout BC ought to be heard in current and future policy work to address the costs of poverty. We have the wisdom, for example, to design and implement safe parenting programs for single mothers; to structure and deliver more equitable home care services for chronically ill older adults; and to plan and implement acute and rehabilitative substance use programs. Furthermore, we have the education, experience, and insight required to foster ethical policy changes at provincial and national levels.

As the ARNBC continues its evolution over the next year, all of us on the Board will look forward to working with you to determine how nurses throughout BC can be better heard on policy issues--such as poverty--that have such profound impacts on health and health care in BC.

The full CCPA report is a well formatted and highly readable 44 pages. You can download it at www.policyalternatives.ca/costofpovertybc.You can also watch a related video and download a 4 page summary at the same web link.


Paddy Rodney, RN is a nurse educator with a specialty in ethics. Her early clinical and teaching background was in critical care nursing. Paddy is currently an Associate Professor at the UBC School of Nursing and is affiliated with the UBC Centre for Applied Ethics, Providence Health Care Ethics Services, and the Canadian Bioethics Society. Over the last 25 years, she has lectured and consulted on nursing ethics for nursing associations and unions. Paddy was also actively involved in the last three revisions of the Canadian Nurses Association Code of Ethics for Registered Nurses.

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Patricia Foster

Thank you for drawing my attention to this document. I work in a primary health care setting with clients who live with complex chronic health issues, chronic pain being the most pressing one. Poverty compromises any attempt to find health within chronic illness, especially for rehab and allied services that are not funded through MSP. In addition, for many of our clients stable affordable housing is a challenge and we know that a roof over one's head is the first step to any health journey.

I too hope nurses can bring a voice to this issue. I believe solical justice must be a core value for our profession.