tag:theconversation.com,2011:/us/topics/socio-economic-conditions-35051/articlesSocio-economic conditions – The Conversation2024-03-04T20:04:37Ztag:theconversation.com,2011:article/2249112024-03-04T20:04:37Z2024-03-04T20:04:37Z10 reasons why Canadians are still dissatisfied with the economy, despite the upswing<figure><img src="https://images.theconversation.com/files/579277/original/file-20240301-24-yhh7th.jpg?ixlib=rb-1.1.0&rect=69%2C62%2C4531%2C3004&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Recent surveys suggest Canadians are dissatisfied with the direction of the economy. </span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><p>The COVID-19 pandemic <a href="https://www.cbc.ca/news/health/who-pandemic-not-emergency-1.6833321">is no longer a global emergency</a>, Canada’s GDP <a href="https://www.ctvnews.ca/business/economic-bounce-back-at-the-end-of-2023-could-push-back-rate-cuts-economists-say-1.6749435">outperformed expectations in 2023</a>, the economy seems to be heading for <a href="https://www.theglobeandmail.com/business/economy/article-statistics-canada-november-gdp-economy">soft landing after a period of stagnation</a>, inflation is <a href="https://www.cbc.ca/news/business/inflation-january-2024-1.7119796">winding down</a> and unemployment has decreased to <a href="https://www150.statcan.gc.ca/n1/daily-quotidien/240209/cg-a002-eng.htm">5.7 per cent in January 2024</a> — close to pre-pandemic levels. </p>
<p>Despite these positive economic indicators, recent surveys suggest Canadians are <a href="https://policyoptions.irpp.org/magazines/december-2023/canadians-unhappy/">dissatisfied with the direction of the economy</a>. An overwhelming <a href="https://www.ipsos.com/en-ca/pessimism-mounts-about-future-economy-and-affordability">84 per cent of Canadians</a> believe the country is already in a recession, with 73 per cent anticipating one within the next year. <a href="https://www.cbc.ca/documentarychannel/features/generation-fear-how-bad-news-has-created-an-anxious-generation">Young people, in particular, are fearful of the future</a>.</p>
<p>This discrepancy prompts the question: Why are Canadians’ sentiments so <a href="https://www.theglobeandmail.com/business/article-canada-economy-mental-health/">at odds with economic indicators</a>? As economists, we have identified several reasons that explain why this gap exists.</p>
<h2>1. Growing socio-economic divide</h2>
<p><a href="https://www.thestar.com/business/gap-between-canada-s-rich-and-poor-increasing-at-record-speed-new-statcan-data-shows/article_c1477d8f-4961-5691-9179-a5b8cabaace9.html">Income and wealth inequality</a> are both growing at an alarming rate in Canada. <a href="https://www150.statcan.gc.ca/n1/daily-quotidien/230704/dq230704a-eng.htm?HPA=1">The wealthiest 20 per cent now</a> account for more than two-thirds of net worth, compared to the 2.7 per cent held by the bottom 40 per cent.</p>
<p><a href="https://www150.statcan.gc.ca/n1/daily-quotidien/240122/t001a-eng.htm">The top 20 per cent accounted</a> for 40.3 per cent of net disposable income in 2023, while the bottom 20 per cent accounted for just 6.1 per cent. The <a href="https://globalnews.ca/news/10085442/canada-top-income-earners-post-covid/">top one per cent of earners</a>, meanwhile, have grown even richer. </p>
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<a href="https://theconversation.com/two-thirds-of-canadian-and-american-renters-are-in-unaffordable-housing-situations-221954">Two-thirds of Canadian and American renters are in unaffordable housing situations</a>
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<p>In contrast, the number of people in the <a href="https://www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=1110024101">low-income cutoff group</a> keeps increasing. Net saving for the lowest income households decreased by <a href="https://www150.statcan.gc.ca/n1/daily-quotidien/240122/dq240122a-eng.htm">9.8 per cent</a> in the third quarter of 2023 compared to the previous year.</p>
<h2>2. Debt servicing burdens</h2>
<p>Since the onset of the pandemic, net savings have deteriorated for all except those with the highest incomes, as renters and lower-income families tend to spend more than they make on necessities.</p>
<p>Canada currently holds the <a href="https://www150.statcan.gc.ca/n1/en/pub/11-631-x/11-631-x2024002-eng.pdf?st=ytPi2j-5">highest amount of household debt as a percentage of disposable income</a> among all G7 countries. With the current high interest rates, the burden of interest payments for households as a percentage of disposable income recently reached its highest level in 12 years.</p>
<h2>3. Interest rates</h2>
<p>The average disposable income for the <a href="https://www150.statcan.gc.ca/n1/daily-quotidien/240122/dq240122a-eng.htm">top 20 per cent of Canadians is increasing at the fastest rate</a> of any income group. This means those with financial assets benefit from rising interest rates, while those at the bottom suffer from the burden of greater debt service.</p>
<h2>4. Housing costs</h2>
<p>Skyrocketing housing prices have outpaced income and mortgage rates have gone up dramatically, resulting in the lowest <a href="https://globalnews.ca/news/10167093/housing-affordability-bank-canada-index/">home affordability index</a> in the last 40 years. The dream of home ownership seems more distant than ever for many.</p>
<h2>5. Impact of inflation</h2>
<p>Although <a href="https://www.reuters.com/world/americas/canadas-inflation-rate-drops-more-than-expected-29-january-2024-02-20/">Canada’s inflation rate shows signs of slowing</a>, it still remains fairly high. It reached <a href="https://www.cbc.ca/news/business/canada-inflation-rate-1.6526060">a 39-year high of 8.1 per cent in June 2022</a>, hitting <a href="https://globalnews.ca/news/9474837/low-income-canadians-inflation-statcan-report/">those in low-income groups</a> the hardest.</p>
<h2>6. Growing corporate concentration</h2>
<p>Canada’s most concentrated industries have become even <a href="https://www.bnnbloomberg.ca/competitive-decline-hurting-canadian-consumers-businesses-comp-bureau-1.1986903">less competitive</a>, and the number of highly concentrated industries is growing. <a href="https://www.cbc.ca/news/business/canada-competition-bureau-report-1.7001320">Profit margins</a> and markups of already profitable firms is increasing. </p>
<p>This trend negatively impacts consumers and broader society by reducing industry dynamism, resulting in fewer choices and higher costs. </p>
<p>We are seeing this currently play out in the grocery sector, where <a href="https://theconversation.com/increasing-monopoly-power-poses-a-threat-to-canadas-post-pandemic-economic-recovery-209308">a lack of competition has resulted in higher food prices</a>. This is the same reason why <a href="https://www.ionajournal.ca/exchange/2023/1/21/sky-high-prices-why-its-so-expensive-to-fly-in-canada-and-how-to-change-this">airplane tickets</a> and <a href="https://www.cbc.ca/news/business/marketplace-high-cell-phone-bills-1.6711205">cell phone bills</a> remain higher in Canada than in comparable countries.</p>
<h2>7. Mental health struggles</h2>
<p>The proportion of people reporting very good or excellent mental health <a href="https://www150.statcan.gc.ca/n1/daily-quotidien/230913/dq230913b-eng.htm">decreased to 59 per cent in 2021 from 72.4 per cent in 2015</a>. </p>
<p>The prevalence of some chronic conditions, including high blood pressure, heart disease and obesity, increased from 2015 to 2021 as well. </p>
<p>Financial anxiety, pandemic-related stress and other issues are making <a href="https://www.thestar.com/life/are-canadians-getting-angrier-heres-what-experts-say-is-happening-and-how-we-can-tame/article_6457ee6a-56ce-5d84-a2ea-53b3bef15ed5.html">Canadians feel angrier in general</a>, which affects their outlook on life and the economy.</p>
<h2>8. Long COVID</h2>
<p>While the impacts of the pandemic are slowing down, long COVID is still a significant issue for many. <a href="https://www.cbc.ca/news/health/long-covid-symptoms-canadians-1.7053485">One in nine people</a> who contracted COVID-19 suffer from symptoms, including brain fog, <a href="https://doi.org/10.1056/NEJMoa2311330">cognitive impairment</a>, fatigue and shortness of breath, that affect their health and well-being. </p>
<p>It is shortsighted to assume we have all recovered equally from the pandemic when some people are still being affected by it.</p>
<h2>9. Higher education funding cuts</h2>
<p>College education has historically served as “<a href="https://www.britannica.com/topic/Education-The-Great-Equalizer-2119678">the great equalizer</a>” and an instrument of intergenerational social mobility, but in the face of <a href="https://universityaffairs.ca/news/news-article/the-rising-financial-precarity-of-universities/">declining government support for post-secondary education</a>, this may no longer be the case. </p>
<p>The financial situation of many colleges is <a href="https://www.thestar.com/politics/provincial/almost-half-of-ontario-universities-are-running-deficits-putting-student-services-at-risk-council-says/article_639ebedc-af31-11ee-bdce-47e37d4e1808.html">increasingly precarious</a>, meaning post-secondary institutions could end up raising tuition fees or rely more on international students to meet their budgets, both of which affect domestic students. </p>
<p>Students from the lowest economic stratum will increasingly find it difficult to trade the security of a job right out of high school for the high cost of a university or college degree. This, in turn, will reduce their chances to move up in the socio-ecnomic ladder.</p>
<h2>10. Youth struggles</h2>
<p><a href="https://www.nytimes.com/2024/01/29/upshot/teens-politics-mental-health.html">Youth across North America</a> are more anxious about their future, concerned about their mental health and educational prospects and more disillusioned by politicians than previous generations. </p>
<p>Despite being resilient and pragmatic, <a href="https://globalnews.ca/news/8360411/gen-z-canada-future-youth-leaders/">Gen Z are pessimistic about the world around them</a> and the future ahead. They worry about their financial security, with high costs of rent and groceries. </p>
<p><a href="https://www.theglobeandmail.com/canada/article-gen-z-is-a-climate-anxious-pessimistic-force-to-be-reckoned-with">A 2023 survey from the <em>Globe and Mail</em></a> found that nearly three-quarters of Gen Z disagreed that, as a generation, they would surpass their parents. Fifty-six per cent feel afraid, sad, anxious and <a href="https://doi.org/10.1016/j.joclim.2023.100204">powerless about climate changes</a>, while 78 per cent reported that climate anxiety is impacting their mental health. </p>
<h2>Navigating the disconnect</h2>
<p>While more than <a href="https://angusreid.org/2024-canada-optimism-pessimism-expectations/">40 per cent of Canadians</a> hope for positive outcomes in 2024 and the macroeconomic indicators show prosperity, there exist numerous factors causing dissatisfaction in large swathes of the population in Canada. </p>
<p>Managers, business leaders, policymakers, government officials and economists should all care deeply about this issue. Over-relying on aggregate indicators — like macroeconomic prosperity — while making strategic, investment, hiring and financing decisions could lead to unexpected outcomes and challenges.</p>
<p>For example, a real estate company might decide to invest in a large, low-end housing project based on economic numbers. While the initial logic may seem sound — if the economy is doing well, that there should be a huge demand for housing — issues might arise if the target population is financially strained and unable to afford the housing.</p>
<p>A comprehensive understanding of the mindset, risk preferences and motivating factors of key customers, stakeholders, investors, employees and voters is essential for making well-informed decisions that benefit all parties involved.</p><img src="https://counter.theconversation.com/content/224911/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Anup Srivastava receives research funding from the Social Sciences and Humanities Research Council of Canada.</span></em></p><p class="fine-print"><em><span>Felipe Bastos Gurgel Silva, Luminita Enache, and Manuela Dantas do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>There are a number of reasons why there’s such a significant gap between aggregate economic numbers and the perceptions of everyday people.Anup Srivastava, Professor and Canada Research Chair, Haskayne School of Business, University of CalgaryFelipe Bastos Gurgel Silva, Assistant Professor, Trulaske College of Business, University of Missouri-ColumbiaLuminita Enache, Associate Professor of Accounting and Future Fund Fellow, Haskayne School of Business, University of CalgaryManuela Dantas, Assistant Professor, Department of Accounting, California State University, NorthridgeLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2037912023-04-23T08:53:14Z2023-04-23T08:53:14ZGreen spaces are good for people – but in South Africa many cannot access them<figure><img src="https://images.theconversation.com/files/521056/original/file-20230414-26-ynnjdo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Fetching water is a chore, but some women also said it was a welcome opportunity to be in nature.
</span> <span class="attribution"><span class="source">Tony Dold</span></span></figcaption></figure><p>The <a href="https://dukespace.lib.duke.edu/dspace/bitstream/handle/10161/11477/Russell?sequence=1">benefits</a> of experiencing nature for <a href="https://www.nature.com/articles/s41598-019-44097-3">physical</a>, <a href="https://www.apa.org/monitor/2020/04/nurtured-nature">psychological</a> and <a href="https://www.researchgate.net/publication/286671347_Enhancing_spirituality_and_positive_well-being_through_nature">spiritual</a> well-being are widely documented. But much of the research on these benefits has been done in relatively affluent countries in the global North. There’s <a href="https://www.sciencedirect.com/science/article/pii/S2666049022000263?via%3Dihub">little research</a> that has been done in developing countries on the benefits of being in nature. </p>
<p>Development and urban planning approaches in developing countries <a href="https://research.vu.nl/en/publications/poorer-without-it-the-neglected-role-of-the-natural-environment-i">reflect this</a>. While they rightfully emphasise economic development, housing and sanitation, they commonly treat access to green space as a luxury to enjoy once basic needs are met.</p>
<p>In an era of accelerating urbanisation, particularly in developing countries, nature experience is becoming increasingly rare. And as with many other types of amenities, access to nature and green spaces is highly <a href="https://www.eea.europa.eu/publications/who-benefits-from-nature-in">skewed</a> along socio-economic lines. </p>
<p>In South Africa, there remains a stark contrast in access to nature and green spaces between areas that were divided along racial lines during apartheid. It includes highly uneven distribution of city trees and green spaces, a situation that has been dubbed “<a href="https://journals.sagepub.com/doi/10.1177/25148486221110438">green apartheid</a>”.</p>
<h2>Our research</h2>
<p>We have been <a href="https://link.springer.com/article/10.1007/s11205-023-03063-3">researching</a> for the past decade the relationships isiXhosa-speaking people in urban and rural settings in South Africa’s Eastern Cape Province have with their natural environment. Our definition of “nature” includes anything from dense natural forest in rural areas, to patches of bush and communal grazing land around towns and villages.</p>
<p>We found that across a range of urban to rural locations, age and gender, most people we interviewed had a strong <a href="https://archive.sajs.co.za/index.php/SAJS/article/view/880/1195">appreciation</a> for nature. Even though many had limited access to natural spaces, and seldom visited them, they <a href="https://bioone.org/journals/journal-of-ethnobiology/volume-36/issue-4/0278-0771-36.4.820/Ways-of-Belonging--Meanings-of-Nature-AMong-Xhosa-Speaking/10.2993/0278-0771-36.4.820.full">valued</a> such spaces for their contribution to a sense of well-being, identity and shared heritage. Many also <a href="https://core.ac.uk/download/pdf/145055514.pdf">described</a> how visiting nature eased feelings of hardship, stress, and loneliness.</p>
<p>Employment, housing, water and sanitation remain urgent priorities for urban and rural development. Nevertheless, as our research shows, the contribution access to nature makes to people’s well-being is important. Growing <a href="https://natureplayqld.org.au/wp-content/uploads/2022/02/rbg260-nature-for-health-and-wellbeing-report-fa-r3-spreads.pdf">evidence</a> suggests that access to green space has the most pronounced benefits among the lowest socioeconomic groups.</p>
<p>Making access to nature a luxury that few can afford continues to reinforce existing patterns of deep inequality.</p>
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Read more:
<a href="https://theconversation.com/growing-plants-on-buildings-can-reduce-heat-and-produce-healthy-food-in-african-cities-191190">Growing plants on buildings can reduce heat and produce healthy food in African cities</a>
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<h2>Relationships with nature</h2>
<p>To test the generality of our qualitative findings, we conducted an in-depth, questionnaire-based survey of nearly 700 Eastern Cape rural and urban residents. This included questions about respondents’ feelings of attachment to nature, past and present nature access and resource use, cultural and religious beliefs and practices, and socio-economic indicators.</p>
<p>We also explored the contribution that being in nature made to the best and worst times respondents remembered experiencing during their life.</p>
<p>Religion and spirituality featured strongly in the lives of people we interviewed. Three quarters of respondents practised both Christian and African indigenous religions, including recognition of ancestral spirits. Only 1% neither belonged to a church nor held African indigenous religious beliefs. Ninety percent of respondents engaged in various rituals including male initiations, and many of these require time spent in natural settings and use of natural products. </p>
<p>Access to nature thus helps to ensure that spirituality remains a part of everyday reality, and vice versa.</p>
<p>We asked respondents to remember and describe the happiest period they had experienced in their lives, and whether being in nature featured and contributed. The most commonly reported best time was childhood or youth, often associated with rural life and being in nature. People reminisced about stick fighting and traditional parties for young people, safe spaces for teenage courtship in nature and swimming in rivers and dams.</p>
<p>Other times widely remembered as the best in people’s lives were associated with educational and related achievements, marriage and relationships, the birth of children, and men’s time spent in the bush as part of their traditional initiation into manhood. </p>
<p>Overall, best periods strongly related to social aspects of life, such as family relationships, community and personal achievements. Only 27% of respondents mentioned best times that reflected material domains such as work, money or housing.</p>
<p>Fifty-six percent of the respondents said they accessed nature during the best time in their life, and nearly all of those (94%) felt that accessing nature contributed to it being the best time in their life. The reasons for this included the contribution of being in nature to a sense of well-being and joy, and as a site for celebrations, recreation and ritual practices.</p>
<p>We also asked respondents to describe the worst time they had experienced in their life. The death of loved ones was overwhelmingly associated with the worst period. Other worst experiences included ill health or injury, and setbacks or failure in life. Thirty-six percent of respondents reported spending time in nature during this difficult time, and of these, 74 % felt that it helped them cope better. </p>
<p>Mourners found that experiencing peace and calm in nature assisted with the healing process. Some respondents said the peaceful surroundings were conducive to prayer. Others felt the presence of the ancestors when being in nature. </p>
<p>Of those who did not spend time in nature during their most difficult time, 30% thought that it might have helped them cope better. Overall, 45% of respondents felt that accessing nature either helped or could have helped them deal with the worst time in their lives. </p>
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<img alt="A group of children swimming" src="https://images.theconversation.com/files/521628/original/file-20230418-14-gwlihx.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/521628/original/file-20230418-14-gwlihx.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=402&fit=crop&dpr=1 600w, https://images.theconversation.com/files/521628/original/file-20230418-14-gwlihx.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=402&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/521628/original/file-20230418-14-gwlihx.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=402&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/521628/original/file-20230418-14-gwlihx.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=505&fit=crop&dpr=1 754w, https://images.theconversation.com/files/521628/original/file-20230418-14-gwlihx.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=505&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/521628/original/file-20230418-14-gwlihx.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=505&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Access to nature benefits children’s mental and physical health but this is becoming more difficult in urban areas.</span>
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<h2>Nature access: a basic necessity or a luxury?</h2>
<p>The rural areas and urban townships of the Eastern Cape are among the <a href="https://southafrica-info.com/people/mapping-poverty-in-south-africa/">least developed</a> in South Africa. They are characterised by high rates of <a href="https://journals.co.za/doi/full/10.10520/ejc-ajpa_v12_n1_a8">poverty</a>, dependence on social welfare, unemployment, poor access to quality schooling and medical care, and high rates of crime, including gender-based violence. </p>
<p>Within this context, we found that well-being and happiness are multidimensional and strongly enhanced by social and family relationships, religion and spirituality, and access to natural spaces for material, recreational and spiritual purposes. </p>
<p>Unfortunately, access to natural spaces is becoming increasingly difficult and dangerous for many people, especially women and girls and in urban areas. For <a href="https://link.springer.com/article/10.1007/s10745-015-9755-z">children</a>, and especially girls, fear of crime and competing expectations around the home are limiting opportunities to play outdoors in natural spaces. This means they miss out on the benefits that being in nature has for <a href="https://jech.bmj.com/content/72/10/958#T2">mental</a> and physical health in children.</p><img src="https://counter.theconversation.com/content/203791/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Susanne Vetter receives funding from The South African National Research Foundation and Rhodes University.</span></em></p><p class="fine-print"><em><span>Michelle Cocks receives funding from National Research Foundation (NRF) and South Africa-Netherlands Research Programme on Alternatives in Development (SANPAD).</span></em></p><p class="fine-print"><em><span>Valerie Møller receives funding from South African National Research Foundation.</span></em></p>Experiencing nature helps people in times of joy and pain. However, inequity of access to green spaces means that South Africans cannot enjoy nature when they need to.Susanne Vetter, Associate Professor, Department of Botany, Rhodes UniversityMichelle Cocks, Associate Professor of Environmental Anthropology, Rhodes UniversityValerie Møller, Professor of Sociology, Rhodes UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1942772023-01-27T10:25:31Z2023-01-27T10:25:31ZArtificial intelligence in South Africa comes with special dilemmas – plus the usual risks<figure><img src="https://images.theconversation.com/files/503376/original/file-20230106-13-750vf8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">3rdtimeluckystudio/Shutterstock</span></span></figcaption></figure><p>When people think about artificial intelligence (AI), they may have visions of the future. But AI is already here. At its base, it is the recreation of aspects of human intelligence in computerised form. Like human intelligence, it has wide application. </p>
<p>Voice-operated personal assistants like <a href="https://theconversation.com/artificial-intelligence-has-a-gender-bias-problem-just-ask-siri-123937">Siri</a>, self-driving cars, and <a href="https://openai.com/blog/chatgpt/">text</a> and <a href="https://theconversation.com/text-to-image-ai-powerful-easy-to-use-technology-for-making-art-and-fakes-195517">image</a> generators all use AI. It also curates our social media feeds. It helps companies to detect <a href="https://researchberg.com/index.php/rrst/article/view/37">fraud</a> and <a href="https://link.springer.com/article/10.1007/s43681-022-00166-4">hire employees</a>. It’s used to manage <a href="https://www.sciencedirect.com/science/article/abs/pii/S0959652621041251">livestock</a>, <a href="https://edis.ifas.ufl.edu/publication/AE571">enhance crop yields</a> and <a href="https://link.springer.com/chapter/10.1007/978-3-030-40850-3_2">aid medical diagnoses</a>.</p>
<p>Alongside its growing power and <a href="http://dx.doi.org/10.1038/s41467-019-14108-y">its potential</a>, AI raises <a href="https://link.springer.com/article/10.1007/s10551-022-05060-x">moral and ethical questions</a>. The technology has already been at the centre of <a href="https://www.theguardian.com/news/2018/mar/17/cambridge-analytica-facebook-influence-us-election">multiple scandals</a>: the <a href="https://theconversation.com/artificial-intelligence-carries-a-huge-upside-but-potential-harms-need-to-be-managed-173073">infringement of laws and rights</a>, as well as <a href="https://www.propublica.org/article/machine-bias-risk-assessments-in-criminal-sentencing">racial</a> and <a href="https://ainowinstitute.org/AI_Now_2018_Report.pdf">gender</a> discrimination. In short, it comes with a litany of ethical risks and dilemmas.</p>
<p>But what exactly are these risks? And how do they differ among countries? To find out, <a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4240356">I undertook</a> a thematic review of literature from wealthier countries to identify six high-level, universal ethical risk themes. I then interviewed experts involved in or associated with the AI industry in South Africa and assessed how their perceptions of AI risk differed from or resonated with those themes.</p>
<p>The findings reflect marked similarities in AI risks between the global north and South Africa as an example of a <a href="https://theconversation.com/developing-countries-are-being-left-behind-in-the-ai-race-and-thats-a-problem-for-all-of-us-180218">global south nation</a>. But there were some important differences. These reflect South Africa’s <a href="https://www.worldbank.org/en/news/press-release/2022/03/09/new-world-bank-report-assesses-sources-of-inequality-in-five-countries-in-southern-africa#:%7E:text=South%20Africa%2C%20the%20largest%20country,World%20Bank%27s%20global%20poverty%20database.">unequal society</a> and the fact that it is on the periphery of AI development, utilisation and regulation.</p>
<p>Other developing countries that share similar features – a vast <a href="https://mg.co.za/opinion/2022-11-10-south-africa-must-bridge-digital-divide-to-best-benefit-from-4ir/">digital divide</a>, high <a href="https://time.com/6087699/south-africa-wealth-gap-unchanged-since-apartheid/">inequality</a> and <a href="https://www.bloomberg.com/news/articles/2022-11-29/south-africa-jobless-rate-drops-to-third-highest-in-the-world?leadSource=uverify%20wall">unemployment</a> and <a href="https://www.imf.org/en/Publications/WP/Issues/2019/03/01/Struggling-to-Make-the-Grade-A-Review-of-the-Causes-and-Consequences-of-the-Weak-Outcomes-of-46644">low quality</a> education – likely have a similar risk profile to South Africa. </p>
<p>Knowing what ethical risks may play out at a country level is important because it can help policymakers and organisations to adjust their risk management policies and practices accordingly.</p>
<h2>Universal themes</h2>
<p>The six universal ethical risk themes I drew from reviewing global north literature were: </p>
<ul>
<li><p><strong>Accountability</strong>: It is unclear who is accountable for the outputs of AI models and systems.</p></li>
<li><p><strong>Bias</strong>: Shortcomings of algorithms, data or both entrench bias.</p></li>
<li><p><strong>Transparency</strong>: AI systems operate as a “black box”. Developers and end users have a limited ability to understand or verify the output.</p></li>
<li><p><strong>Autonomy</strong>: Humans lose the power to make their own decisions.</p></li>
<li><p><strong>Socio-economic risks</strong>: AI may result in job losses and worsen inequality.</p></li>
<li><p><strong>Maleficence</strong>: It could be used by criminals, terrorists and repressive state machinery.</p></li>
</ul>
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Read more:
<a href="https://theconversation.com/in-a-world-first-south-africa-grants-patent-to-an-artificial-intelligence-system-165623">In a world first, South Africa grants patent to an artificial intelligence system</a>
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<p>Then I interviewed 16 experts involved in or associated with South Africa’s AI industry. They included academics, researchers, designers of AI-related products, and people who straddled the categories. For the most part, the six themes I’d already identified resonated with them. </p>
<h2>South African concerns</h2>
<p>But the participants also identified five ethical risks that reflected South Africa’s country-level features. These were:</p>
<ul>
<li><p><strong>Foreign data and models</strong>: Parachuting data and AI models in from elsewhere.</p></li>
<li><p><strong>Data limitations</strong>: Scarcity of data sets that represent, reflect local conditions.</p></li>
<li><p><strong>Exacerbating inequality</strong>: AI could deepen and entrench existing socio-economic inequalities.</p></li>
<li><p><strong>Uninformed stakeholders</strong>: Most of the public and policymakers have only a crude understanding of AI.</p></li>
<li><p><strong>Absence of policy and regulation</strong>: There are currently no specific legal requirements or overarching government positions on AI in South Africa.</p></li>
</ul>
<h2>What it all means</h2>
<p>So, what do these findings tell us?</p>
<p>Firstly, the universal risks are mostly technical. They are linked to the features of AI and have technical solutions. For instance, bias can be <a href="https://link.springer.com/article/10.1007/s44206-022-00017-z">mitigated</a> by more accurate models and comprehensive data sets. </p>
<p>Most of the South African-specific risks are more socio-technical, manifesting the country’s environment. An absence of policy and regulation, for example, is not an inherent feature of AI. It is a symptom of the country being on the periphery of technology development and related policy formulation. </p>
<p>South African organisations and policymakers should therefore not just focus on technical solutions but also closely consider AI’s socio-economic dimensions.</p>
<p>Secondly, the <a href="https://www.ipsos.com/sites/default/files/ct/news/documents/2022-01/Global-opinions-and-expectations-about-AI-2022.pdf">low levels of awareness</a> among the population suggest there is little pressure on South African organisations to demonstrate a commitment to ethical AI. In contrast, organisations in the global north have to show cognisance of AI ethics, because their <a href="https://link.springer.com/article/10.1007/s43681-021-00068-x">stakeholders</a> are more attuned to their rights vis-à-vis digital products and services.</p>
<p>Finally, whereas the <a href="https://uploads-ssl.webflow.com/614b70a71b9f71c9c240c7a7/62fbe1c37eff7d304f0803ac_Brussels_Effect_GovAI.pdf">EU</a>, <a href="https://www.gov.uk/government/news/uk-sets-out-proposals-for-new-ai-rulebook-to-unleash-innovation-and-boost-public-trust-in-the-technology">UK</a> and <a href="https://www.whitehouse.gov/ostp/ai-bill-of-rights/what-is-the-blueprint-for-an-ai-bill-of-rights/">US</a> have nascent rules and regulations around AI, South Africa has no regulation and <a href="https://uir.unisa.ac.za/bitstream/handle/10500/28134/thesis_jogi_aa.pdf?sequence=1&isAllowed=y">limited laws</a> relevant to AI. </p>
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<em>
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Read more:
<a href="https://theconversation.com/artificial-intelligence-carries-a-huge-upside-but-potential-harms-need-to-be-managed-173073">Artificial intelligence carries a huge upside. But potential harms need to be managed</a>
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<p>The South African government has also <a href="https://www.orfonline.org/research/g20-ai-national-strategies-global-ambitions/">failed</a> to give much recognition to AI’s broader impact and ethical implications. This differs even from <a href="https://www.orfonline.org/research/g20-ai-national-strategies-global-ambitions/">other emerging markets</a> such as Brazil, <a href="https://ai.altadvisory.africa/wp-content/uploads/AI-Governance-in-Africa-2022.pdf">Egypt</a>, India and <a href="https://ai.altadvisory.africa/wp-content/uploads/AI-Governance-in-Africa-2022.pdf">Mauritius</a>, which have national policies and strategies that encourage the responsible use of AI.</p>
<h2>Moving forward</h2>
<p>AI may, for now, seem far removed from South Africa’s prevailing socio-economic challenges. But it will become pervasive in the coming years. South African organisations and policymakers should proactively govern AI ethics risks. </p>
<p>This starts with acknowledging that AI presents threats <a href="https://theconversation.com/defining-whats-ethical-in-artificial-intelligence-needs-input-from-africans-171837">that are distinct from those in the global north</a>, and that need to be managed. Governing boards should add AI ethics to their agendas, and policymakers and members of governing boards should become educated on the technology. </p>
<p>Additionally, AI ethics risks should be added to corporate and government risk management strategies – similar to <a href="https://www.oecd-ilibrary.org/sites/272d85c3-en/index.html?itemId=/content/publication/272d85c3-en">climate change</a>, which received scant attention 15 or 20 years ago but now features prominently. </p>
<p>Perhaps most importantly, the government should build on the recent <a href="https://www.uj.ac.za/news/south-africas-new-national-artificial-intelligence-institute-can-help-transform-our-economy/">launch</a> of the Artificial Intelligence Institute of South Africa, and introduce a tailored national strategy and appropriate regulation to ensure the ethical use of AI.</p><img src="https://counter.theconversation.com/content/194277/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Emile Ormond does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Artificial Intelligence comes with a litany of ethical risks and dilemmas. Some are universal, but some are unique to particular countries, like South Africa.Emile Ormond, PhD on AI Ethics, Governance, University of South AfricaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1547292021-02-10T00:28:17Z2021-02-10T00:28:17ZTest or invest? NZ’s sliding international student assessment rankings are all about choices<figure><img src="https://images.theconversation.com/files/383174/original/file-20210209-15-1ow3mkv.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C5463%2C3645&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">www.shutterstock.com</span></span></figcaption></figure><p>Recent news about New Zealand’s <a href="https://www.rnz.co.nz/news/national/435774/experts-urge-overhaul-of-school-system-following-falling-student-achievement">declining position</a> in international educational assessment rankings has been treated as if it is a new phenomenon requiring drastic changes to the school system. </p>
<p>But some suggested solutions, such as the <a href="https://www.rnz.co.nz/news/national/435607/principals-challenge-education-ministry-over-student-failure">Principals Federation’s call</a> for greater involvement by the Ministry of Education in curriculum decisions, seem simplistic. Problems in education are more complex and relate to the relationship of schooling to society in general.</p>
<p>It’s worth noting that when these international large-scale assessments (e.g. <a href="https://www.oecd.org/pisa/">PISA</a> and <a href="https://timssandpirls.bc.edu/">TIMSS</a>) were first deployed in the 1990s, New Zealand scored in the top five or 10 of all participating countries at <a href="https://www.educationcounts.govt.nz/publications/series/2539/PIRLS-2001/reading_achievement_in_new_zealand_in_1990_and_2001_results_from_the_trends_in_ieas_reading_literacy_study">year 5</a>, <a href="https://www.researchgate.net/publication/232989654_Trends_1995-2000_in_the_TIMSS_Mathematics_Performance_Assessment_in_The_Netherlands/figures?lo=1">year 8</a> and <a href="https://www.educationcounts.govt.nz/data-services/international/pisa/pisa_2000">year 11</a>. Since then scores have fallen to the middle of the pack, although slightly above average. </p>
<p>This is disappointing, but before we become overly concerned, a number of factors need to be considered.</p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1357076015542013952"}"></div></p>
<h2>Being good at tests counts</h2>
<p>The international tests can only test those things that are readily evaluated on either paper or a screen with text. Of all the things that are valuable to our children, these tests measure a very narrow, albeit important, slice of the school curriculum.</p>
<p>While the international test agencies do everything they can to ensure test content is valid for every society, it is clear that routinely taking tests makes a small contribution to greater success. Practice always improves performance. </p>
<p>Unfortunately, by the time New Zealand children reach 15 (PISA measurement age) they will have had very little opportunity to take multiple-choice tests at school. </p>
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Read more:
<a href="https://theconversation.com/stressed-out-the-psychological-effects-of-tests-on-primary-school-children-58913">Stressed out: the psychological effects of tests on primary school children</a>
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<p>Many schools conduct yearly standardised tests provided by the New Zealand Council for Educational Research (<a href="https://www.nzcer.org.nz/tests/pats">NZCER</a>) or the electronic assessment tools for teaching and learning (<a href="https://e-asttle.tki.org.nz/">e-asTTle</a>) system. </p>
<p>But that is very little compared to children from countries with a <a href="https://newint.org/features/2017/09/01/asian-education">heavy use of testing</a> to motivate and select students, such as China, Japan, Korea and India. Most of the world’s children get tested; New Zealand’s not so much.</p>
<h2>Expectation and performance</h2>
<p>Research shows that when New Zealand students take tests of little personal consequence, they tend not to try very hard. This is true of <a href="https://www.tandfonline.com/doi/abs/10.1080/08957347.2013.853070">students in Nordic countries</a>, too. </p>
<p>In contrast, research is showing that students in Shanghai, for example, treat a test that matters to their country’s reputation nearly as seriously as tests with individual consequences. </p>
<p>New Zealand’s lower scores may simply reflect lower effort on a test that doesn’t personally matter to students. </p>
<p>Although international rankings have declined over the past two decades, it was clear from an overview of New Zealand achievement data some 15 years ago that there was a large discrepancy between what the New Zealand curriculum expected of children and their actual <a href="https://www.educationcounts.govt.nz/publications/schooling2/learners/education-and-learning-outcomes/6858">performance</a>. </p>
<p>This was most notable for Māori and Pasifika children and for those in lower decile schools. Despite the 2007 curriculum review, little has been done in New Zealand to close this gap before students enter secondary schooling.</p>
<figure class="align-center ">
<img alt="School children getting lunch in a canteen" src="https://images.theconversation.com/files/383175/original/file-20210209-23-t24cyk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/383175/original/file-20210209-23-t24cyk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/383175/original/file-20210209-23-t24cyk.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/383175/original/file-20210209-23-t24cyk.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/383175/original/file-20210209-23-t24cyk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/383175/original/file-20210209-23-t24cyk.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/383175/original/file-20210209-23-t24cyk.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Social and educational policies are linked: pupils in Finland receive lunch in their school canteen.</span>
<span class="attribution"><span class="source">GettyImages</span></span>
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<h2>Schooling and society</h2>
<p>Families’ socio-economic resources heavily influence educational achievement. This has been established since the mid-1960s as an important <a href="https://hub.jhu.edu/magazine/2016/winter/coleman-report-public-Education/">causal factor in performance</a>. </p>
<p>Families with good jobs, educated parents, warm and dry homes and access to reasonably priced health care produce children who do well at school. Since the 1990s, New Zealand has become a society <a href="https://www.budget.govt.nz/budget/2020/wellbeing/child-poverty-report/trends-prior-to-covid-19.htm">increasingly unable</a> to ensure such conditions for all children.</p>
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Read more:
<a href="https://theconversation.com/a-level-debacle-has-shattered-trust-in-educational-assessment-144640">A-level debacle has shattered trust in educational assessment</a>
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<p>This means New Zealand is faced with a choice when looking at higher-scoring societies for possible solutions. A clear-eyed examination of those nations may give us some insight into what we could do.</p>
<p>Among the most successful are the high-testing regions of East Asia (Hong Kong, Singapore, China, Korea, Japan, Macau). These jurisdictions regularly test children to rank and sort them even before they enter school. </p>
<p>However, my own <a href="https://www.tandfonline.com/doi/abs/10.1080/03075079.2011.616955">research</a> has shown large psychological and emotional consequences for systems that rank and reward the winners. The tragedy is that creating a <a href="https://journals.sagepub.com/doi/10.3102/0013189X029002004">test-based system</a> is relatively simple and cost-effective, but the human cost is not one I would wish on my own children and grandchildren.</p>
<h2>The Finland model</h2>
<p>A standout <a href="https://www.amazon.com/Finnish-Lessons-2-0-Educational-Finland/dp/0807755850">alternative</a> to this approach is offered by Finland, which has decided that solving educational achievement problems cannot be separated from health, welfare, housing and employment policies. </p>
<p>The Finns expect government agencies to co-ordinate with each other to ensure the socio-economic determinants of achievement were put in place for all children, in conjunction with action taken by schools and their education ministry. </p>
<p>This means not blaming schools and teachers for poor student performance when that performance was a consequence of hunger, unemployment, poor health or myriad other social ills that schooling alone cannot solve. </p>
<p>Seeing educational outcomes as a canary in the coalmine of social well-being has meant all government policy works together to ensure educational equity.</p>
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<strong>
Read more:
<a href="https://theconversation.com/they-believe-in-teachers-and-in-education-for-all-why-finlands-kids-often-top-league-tables-32223">They believe in teachers and in education for all: why Finland's kids often top league tables</a>
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<p>Also, it’s perhaps startling from the perspective of New Zealand’s tradition of experience-based teacher education that all Finnish teachers <a href="https://www.helsinki.fi/en/news/education-news/why-is-finnish-teacher-education-excellent-teacher-training-schools-provide-one-explanation">require masters degrees</a> and to be trained in evidence-based practices before being deployed as schoolteachers. </p>
<p>Those teachers are well paid and have became highly regarded professionals in their community.</p>
<p>The challenge for New Zealand is that Finland’s solution is expensive. It requires great political will and constant attention to the changing factors that undermine societal equity. </p>
<p>Nonetheless, Finland has shown it is possible to change educational outcomes in a coherent and meaningful way.</p><img src="https://counter.theconversation.com/content/154729/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Gavin Brown is affiliated with the Bays Community Housing Trust as a Trustee. BCHT is a non-profit community housing provider. </span></em></p>Training New Zealand students to be better at tests would probably improve their performance. But, as Finland has shown, there are better (if more expensive) alternatives.Gavin Brown, Professor in Educational Assessment, University of Auckland, Waipapa Taumata RauLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/895562018-01-12T00:00:43Z2018-01-12T00:00:43ZHow to stop overdoses? Prevent them to begin with<p>The Public Health Agency of Canada recently released projections that <a href="https://www.canada.ca/en/public-health/news/2017/12/statement_from_theco-chairsofspecialadvisorycommitteeontheepidem.html">2017 will have seen a total of more than 4,000 opioid-related deaths</a>. </p>
<p>This is a catastrophic increase from the <a href="https://www.canada.ca/en/public-health/services/publications/healthy-living/apparent-opioid-related-deaths-report-2016-2017-december.html">2,861 deaths across Canada in 2016</a>. And it confirms, tragically, that the <a href="https://theconversation.com/why-canada-should-declare-a-national-opioid-emergency-too-87325">public health emergency of fatal and non-fatal overdose and drug poisoning</a> continues to take an unprecedented human toll across Canada.</p>
<p>Drug deaths are dramatically outpacing anything we have seen before. For example, British Columbia, the province hardest hit by the crisis, recorded <a href="https://www2.gov.bc.ca/assets/gov/public-safety-and-emergency-services/death-investigation/statistical/illicit-drug.pdf">1,208 lives lost</a> from January to the end of October 2017. This is an increase of 77 per cent over the same period in 2016, and 200 per cent over 2015. </p>
<p>And British Columbia is not alone in these dramatic increases: Data from Ontario report <a href="https://news.ontario.ca/mohltc/en/2017/12/ontario-expanding-opioid-response-as-crisis-grows.html">336 opioid-related deaths</a> from May to July this year, a 68 per cent increase over the same period in 2016.</p>
<p>Laudable responses have rightly focused on immediate health outcomes such as reversing overdoses amid a drug supply contaminated with fentanyl or fentanyl analogues such as carfentanil. </p>
<p>To build a truly effective response to the crisis, however, Canada must also address the socio-economic factors linked to overdose risk — including <a href="https://doi.org/10.1503/cmaj.1031416">homelessness and housing insecurity</a>, <a href="https://www.ncbi.nlm.nih.gov/pubmed/15108744">insufficient support following release from prison</a>, <a href="http://dx.doi.org/10.1371/journal.pone.0125568">severe poverty</a> and <a href="http://dx.doi.org/10.1007/s13524-017-0565-3">low educational attainment</a>.</p>
<h2>Life-saving measures</h2>
<p>Nationally, the percentage of all overdose deaths involving fentanyl has risen to <a href="https://www.canada.ca/en/public-health/services/publications/healthy-living/apparent-opioid-related-deaths-report-2016-2017-december.html">74 per cent in 2017 from 53 per cent in 2016</a>. </p>
<p>These increases seem likely to continue unless we legalize and regulate the drugs at the centre of the crisis. This would allow people to access information about drug potency and purity, but <a href="https://www.thestar.com/news/canada/2017/09/07/pm-says-no-to-decriminalizing-drugs-bc-addictions-minister-open-to-idea.html">the federal government explicitly does not support decriminalization</a>.</p>
<p>In this context, other life-saving responses — including supervised consumption and overdose prevention facilities, drug testing, the distribution of overdose-reversing Naloxone and access to injection and non-injection opioid-assisted treatment — are all expanding. All are crucial in reducing death from overdose. </p>
<p>It is difficult to fathom the size of the death toll if these measures were not in place. </p>
<p>The good news is that <a href="http://www.pivotlegal.org/the_overwhelming_case_for_overdose_prevention_sites">not a single one of the 108,804 visits to the first Overdose Prevention Site on Vancouver’s Downtown Eastside has resulted in a fatality</a>, despite 255 overdoses at the facility between Dec. 25, 2016 and Oct. 9, 2017. </p>
<p>Unquestionably, these efforts are saving lives.</p>
<h2>Limited access to interventions</h2>
<p>Access to overdose-related interventions is restricted geographically and available almost exclusively in urban centres. And the expansion of supervised injection facilities across the country has focused on urban, not rural, areas. Nevertheless, responses to the overdose crisis are gaining momentum.</p>
<p>The <a href="https://www.theglobeandmail.com/news/national/health-canada-proposes-to-allow-doctor-requests-to-prescribe-heroin/article30020597/">federal government is, for example, taking needed steps</a> to support the <a href="http://www.gazette.gc.ca/rp-pr/p1/2017/2017-04-22/html/reg3-eng.html">expanded availability of heroin-assisted treatment</a>. This enables individuals with severe substance use disorder to access medical opioids whose potency and purity is controlled. But it can be challenging to connect people living in rural areas to health services, which may limit their access to treatment. </p>
<p>Even with an overdose-response infrastructure with adequate coverage in place, most of these efforts do not stop overdoses — they merely prevent them from becoming fatal. </p>
<p>To achieve meaningful reductions in overdose death we need to prevent overdoses from occurring in the first place. </p>
<h2>Income assistance an overdose risk</h2>
<p>The most recent <a href="https://www2.gov.bc.ca/assets/gov/public-safety-and-emergency-services/death-investigation/statistical/illicit-drug.pdf">BC Coroners Service report</a> on illicit drug overdose deaths included this startling figure: During the days following income assistance payments, the rate of fatal overdose was significantly higher than at other times of the month. </p>
<p>In the first 10 months of 2017, this amounted to an average of nearly six fatal overdoses per day on the Wednesday to Sunday following income assistance payments, compared to 3.6 deaths per day at other times.</p>
<p>While this report is specific to B.C., most jurisdictions in Canada distribute income assistance in the same way: Once a month to all recipients on the same day.</p>
<p>This data is consistent with <a href="http://dx.doi.org/10.1016/j.socscimed.2016.11.006">existing research linking income assistance to increased drug use</a>. People have known for many years that income assistance payments — a critical component of the social safety net that reduces some of the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1913691/">health harms of poverty</a> — are associated with increases in drug use and <a href="http://dx.doi.org/10.1016/j.drugpo.2016.05.010">overdose risk</a>. </p>
<p>People receiving these payments rely on monthly incomes that keep them significantly below the poverty line. The lack of financial security has negative implications for <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1913691/">drug use</a>, <a href="http://dx.doi.org/10.1136/jech-2014-205079">drug-related harm</a> and <a href="https://doi.org/10.1371/journal.pone.0125568">overdose risk</a>. </p>
<p>Trends like this signal opportunities for action. Considering how social and socio-economic conditions increase overdose risk will be essential to overdose response efforts that adopt a preventive approach.</p>
<h2>Homelessness, unemployment, chronic pain</h2>
<p>Socio-economic marginalization — which includes <a href="https://doi.org/10.3109/00952999709040943">inadequate income</a>, <a href="http://dx.doi.org/10.1111/1467-9566.12344">exclusion from the labour market</a>, participation in illegal or <a href="http://dx.doi.org/10.1136/jech-2014-205079">prohibited income generation</a> like drug-dealing or theft, and <a href="http://dx.doi.org/10.1016/j.drugalcdep.2011.07.008">housing or food insecurity</a> — is a <a href="http://dx.doi.org/10.1136/jech-2014-205079">key driver of illicit drug use and drug-related harm</a>. </p>
<p>This kind of marginalization shapes whether and how people use drugs, how they experience the impacts and their access to a broad range of health and social services. It is relevant to the overdose crisis in many different ways.</p>
<p>For example, when someone loses their housing they may also lose the space, routines and social interactions that allow them to use opioids more safely. </p>
<p>Someone experiencing chronic pain may not have the resources to consistently access care and, as a result, may begin self-medicating with street drugs of unknown potency and purity. </p>
<p>This kind of socio-economic marginalization could also look like someone who goes through a family dissolution, who has to move quickly and often painfully to establish a new domestic situation with less financial and social stability, and who ends up using drugs in high-risk ways. </p>
<p>Or it could take the form of someone being released from prison, not having the resources to transition smoothly or access treatment, and relapsing in the context of a toxic drug supply.</p>
<h2>Broadening overdose prevention</h2>
<p>Current efforts to prevent overdose fatalities are extremely important. They are expanding nationally, as evidenced by the leap from two to 28 <a href="https://www.canada.ca/en/health-canada/services/substance-abuse/supervised-consumption-sites/status-application.html">Health Canada-approved supervised drug consumption facilities</a> in 2017, alongside new overdose prevention sites operating in select locations across the country. </p>
<p>Also critical are interventions to deal with the toxic drug supply. Ideally these would also involve the legalization and regulation of the drugs fuelling the current crisis. </p>
<p>Currently they include expanded <a href="http://www.bccsu.ca/news-release/province-expands-fentanyl-testing-and-launches-drug-checking-pilot-in-vancouver/">drug-testing</a> services and the recent announcement of a <a href="https://www.theglobeandmail.com/news/british-columbia/bc-pilot-project-to-distribute-clean-opioids-to-people-at-high-risk-of-overdose/article37392053/">British Columbia pilot to distribute “clean opioids” (hydromorphone)</a> to people at high risk of overdose.</p>
<p>But, as this public health emergency continues to deepen, we must also incorporate broader understandings of overdose risk into our response and prevention efforts.</p>
<p>Reducing the socio-economic marginalization associated with overdose risk for people who use illicit drugs will be essential. Meaningfully addressing the overdose crisis means addressing the socio-economic factors that increase overdose risk to begin with.</p>
<hr>
<p><em><strong>Read more: <a href="https://theconversation.com/ca/topics/canadas-opioid-crisis-46272">Solutions to Canada’s opioid crisis</a></strong></em></p>
<hr><img src="https://counter.theconversation.com/content/89556/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Lindsey Richardson receives funding from the Michael Smith Foundation for Health Research and the Canadian Institutes of Health Research. </span></em></p><p class="fine-print"><em><span>Jenna Van Draanen receives funding from the Michael Smith Foundation for Health Research. </span></em></p>Catastrophic increases in opioid overdose deaths across Canada require a broad response – tackling housing, food and income insecurity as well as the contaminated drug supply.Lindsey Richardson, Research Scientist, BC Centre on Substance Use and Assistant Professor, Department of Sociology, University of British ColumbiaJenna Van Draanen, Postdoctoral Fellow, University of British ColumbiaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/871642017-11-23T22:46:57Z2017-11-23T22:46:57ZIndigenous women suffer greatest risk of injury<p>Indigenous peoples are more likely to suffer an injury than non-Indigenous peoples — <a href="http://injuryprevention.bmj.com/content/21/e1/e144.short">in Canada and many other nations</a>. This includes injuries at work, falls, transport, suicides, assaults and even injuries resulting from medical errors.</p>
<p>Indigenous women, and those who live on reserve or in rural or remote areas, are at greatest risk of injury, according to results from our research project, <a href="http://dx.doi.org/doi:10.3402/ijch.v72i0.21182">Injury in British Columbia’s Aboriginal Communities</a>, that we conducted with colleagues Andrew Jin, <a href="https://www.uvic.ca/socialsciences/psychology/people/faculty-directory/lalondechristopher.php">Christopher E. Lalonde</a> and <a href="http://kamino.tru.ca/experts/home/main/bio.html?id=rmccormick">Rod McCormick</a>.</p>
<p>This research suggests that addressing inequalities — in income, education, employment, housing conditions and other markers of disadvantage — will help narrow the gap. </p>
<p>It is clear that this gap will not close, however, so long as the effects of <a href="http://www.ahf.ca/downloads/historic-trauma.pdf">post-colonial trauma</a>, <a href="http://nationalpost.com/news/canada/safety-of-first-nations-youth-focus-of-emergency-meeting-in-thunder-bay-ont">racism</a> and <a href="http://www.cbc.ca/radio/thecurrent/the-current-for-november-2-2017-1.4382427/this-is-our-birthright-indigenous-senators-call-on-pm-to-end-discrimination-against-women-in-indian-act-1.4382545">discrimination</a> persist.</p>
<h2>Decline in injury hospitalizations</h2>
<p>As part of the <a href="http://dx.doi.org/doi:10.3402/ijch.v72i0.21182">“RISC” research project</a>, we studied 25 years of injury hospitalization, primary care and worker’s compensation data to learn more about patterns of injury rates across time and among different Indigenous communities and population groups in British Columbia. </p>
<p>The good news is that we found <a href="http://www.statcan.gc.ca/pub/82-003-x/2015001/article/14131-eng.pdf">dramatic reductions over time</a> in rates of injury among the total population and the Indigenous population, in all categories of injury. </p>
<p>Figure 1 shows the decline in overall injury hospitalizations from 1986 to 2010 for male and female Indigenous and total populations in British Columbia.</p>
<p>This pattern applies to <a href="http://dx.doi.org/10.1186/s40621-015-0039-2">both children and adults</a>, <a href="https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-016-3078-x">people living in metropolitan and non-metropolitan areas</a>, <a href="https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-016-3078-x">Indigenous people living on- and off-reserve</a> and to major categories of injury including transportation, <a href="http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0121694">falls</a>, <a href="http://dx.doi.org/10.1353/hpu.2017.0090">injuries resulting from medical errors</a> and <a href="http://dx.doi.org/10.1186/s12939-017-0629-4">intentional injuries</a> (both self-injury and assaults). </p>
<h2>Indigenous women at greater risk</h2>
<p>While these reductions are encouraging, there are still many reasons for serious concern. By the end of our study period in 2010, the Indigenous population remained at <a href="http://www.statcan.gc.ca/pub/82-003-x/2015001/article/14131-eng.pdf">1.1 to 2.8 times greater risk of injury than the total population</a>. The exact risk depends on the category of injury. </p>
<p>Indigenous populations living on reserves or in rural or remote areas are at greatest risk of being injured. While the overall difference in risk between Indigenous and total populations has narrowed over time, more recently, progress has stalled. </p>
<p>In all major categories of injury (<a href="https://doi.org/10.1371/journal.pone.0121694">falls</a>, transportation, <a href="http://muse.jhu.edu/article/666591">medical errors</a> and <a href="https://equityhealthj.biomedcentral.com/articles/10.1186/s12939-017-0629-4">intentional injuries</a>), the disparity between Indigenous females and the total female population is larger than that between Indigenous males and the total male population. </p>
<p>Whatever the factors that put Indigenous people at higher risk, they seem to hurt Indigenous women more than Indigenous men.</p>
<h2>Reduce poverty, increase urbanization</h2>
<p>In our research, we investigated the role of socioeconomic factors (such as income, education, employment and housing conditions) and of geographic location and Indigenous ethnic identity as predictors of injury risk. This is the first time an analysis of all of these factors together, and their impacts on injury risk, has been carried out in Canada.</p>
<p>Our findings suggest that education, income and other socio-economic factors are all linked to injury risk. People with higher education, for example, can make more informed decisions and reduce risky behaviours. People with higher incomes will have better access to safer cars and communities. People with more resources will be more able to fix stairs and other hazards that can lead to falls. </p>
<p>Our findings also suggest that if we can reduce levels of poverty, this would help decrease the likelihood of transport injuries and falls. It would also narrow the gap in risk between the Indigenous and total populations. </p>
<p>These insights offer opportunities. Meaningful policy initiatives could work towards increasing opportunities for high school completion, accessing the work force and otherwise increasing income. This in turn could improve gender and ethnic equity. </p>
<p>The contemporary trend towards increasing urbanization, with more regulated and safer physical environments, and better opportunities for education and employment, will also likely help to reduce risks of falls and transportation injuries. </p>
<h2>Tackling systemic racism</h2>
<p>But this is only half the story with respect to injury risk among Indigenous people. </p>
<p>Reducing poverty and increasing urbanization would probably still not be enough to close the gap for injuries resulting from medical errors and intentional injuries. For these types of injury, a major contributing factor is ethnicity. </p>
<p>That is, being Indigenous in itself contributes to high risk for self-injury, assaults and injuries unintentionally caused by inappropriate or low-quality medical or surgical care. </p>
<p>Our research is the first to demonstrate that being Indigenous is a risk factor for injury, regardless of other socio-economic factors. The likely culprit is the systemic racism that Indigenous people experience as part of their daily lives. </p>
<p>It has been well-described that <a href="http://www.canadasocialreport.ca/IndigenousPeoples/">being Indigenous in Canada</a> means being subjected to cultural, <a href="https://www.statcan.gc.ca/pub/85-002-x/2011001/article/11439-eng.htm">sexual and personal discrimination</a>, <a href="http://www.cbc.ca/news/indigenous/institute-says-60-percent-fn-children-on-reserve-live-in-poverty-1.3585105">poverty</a>, <a href="https://www.amnesty.ca/sites/amnesty/files/iwfa_submission_amnesty_international_february_2014_-_final.pdf">violence</a>, <a href="https://theconversation.com/how-the-genomics-health-revolution-is-failing-ethnic-minorities-86385">health inequality</a>, loss of <a href="https://theconversation.com/why-we-need-first-nations-education-authorities-81934">opportunity for education</a> and economic well-being, and high risk for social issues such as <a href="https://theconversation.com/back-to-the-land-how-one-indigenous-community-is-beating-the-odds-81540">alcoholism and suicides</a>. </p>
<p>Until Canada deals with <a href="https://theconversation.com/the-s-word-just-stop-using-it-83198">the ongoing</a> <a href="https://theconversation.com/media-portrays-indigenous-and-muslim-youth-as-savages-and-barbarians-79153">and systemic racism</a> and <a href="https://theconversation.com/all-mouth-and-no-ears-settlers-with-opinions-83338">post-colonial heritage</a> that <a href="http://www.trc.ca/websites/trcinstitution/File/2015/Findings/Exec_Summary_2015_05_31_web_o.pdf">Indigenous populations endure</a>, disparities in rates for self-injury, assaults and injuries resulting from medical errors will persist.</p><img src="https://counter.theconversation.com/content/87164/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Mariana Brussoni receives funding from the Canadian Institutes of Health Research, the Lawson Foundation and salary support from the BC Children's Hospital Research Institute.</span></em></p><p class="fine-print"><em><span>M. Anne George receives salary support funding from the BC Children's Hospital Research Institute, and she received research funding from the Canadian Institutes of Health Research, Institute of Aboriginal Peoples Health.</span></em></p>Research shows that Indigenous women are at greatest risk of injury within Canada. Income, education and housing inequities play a role. So does systemic racism and post-colonial trauma.Mariana Brussoni, Associate Professor of Pediatrics and Population and Public Health, University of British ColumbiaM. Anne George, Associate Professor Emerita Pediatrics, University of British ColumbiaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/712862017-01-19T15:36:55Z2017-01-19T15:36:55ZHow social factors drive up suicide rates among pregnant women<figure><img src="https://images.theconversation.com/files/153211/original/image-20170118-3885-19e2yr9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Pregnant women in South Africa who live in poor communities are more likely to consider or attempt suicide than the general population.</span> <span class="attribution"><span class="source">Mike Hutchings/Reuters</span></span></figcaption></figure><p>Pregnant women in South Africa who live in poor communities are more likely to consider or attempt suicide than the general population. That’s a <a href="http://link.springer.com/article/10.1007/s00737-016-0706-5">key finding</a> from a recent study we undertook at Hanover Park. </p>
<p>The research found 12% of pregnant women living in low-resource communities had thought of killing themselves during the previous month. In the same period, an additional 6% of pregnant women reported they had started to enact a suicide plan or attempted to end their lives. Rates of depression and anxiety were also found to be elevated among the pregnant women who took part in the study.</p>
<p>These findings mirror research about high rates of suicidal ideation and behaviour among pregnant women elsewhere in the world. A review of 17 studies in high- and low-income countries found the prevalence of suicidal ideation among pregnant and postpartum women ranged from 5% to 18%. Rates were higher among pregnant women living in <a href="http://link.springer.com/article/10.1007%2Fs00737-005-0080-1">low-income countries</a>.</p>
<p>Our study’s most-significant finding was that more than half of the pregnant women who were at risk of suicide did not have a diagnosable depressive or anxiety disorder. Their suicide risk was also associated with lower socioeconomic status, food insecurity, intimate partner violence and a lack of social support.</p>
<p>This suggests suicidal ideation among pregnant women is about more than mental illness. Past studies suggest suicide and mental illness are <a href="http://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/1471-2393-11-57">strongly linked</a>. Pregnant women who are depressed or have problems with anxiety are more likely to experience thoughts of death and engage in suicidal behaviour compared with other pregnant women. </p>
<p>But our research shows social and economic context may be a much more important contributor to suicide risk than previously thought. </p>
<h2>Pernicious impact of adversity</h2>
<p>The findings show the pernicious impact of socioeconomic adversity, interpersonal violence and lack of social support on pregnant women’s wellbeing.</p>
<p>We found pregnant women who are the victims of intimate partner violence are twice as likely to engage in suicidal behaviour compared to other pregnant women. Those who experience food insecurity – either they go hungry regularly or they have considerable trouble feeding themselves and their families – are almost four times more likely to report suicidal behaviour.</p>
<p>Pregnant women who are not in a relationship are also more likely than other pregnant women to experience suicidal thoughts and attempt suicide. And we found suicide risk decreases as pregnant women experience more social support. </p>
<p>These findings add to the growing body of evidence showing that sociocultural and economic factors are important risk factors for suicide. Suicidal ideation and behaviour are not simply a symptom of mental illness. Suicide can be a reaction to living in a particular context or facing stressful circumstances.</p>
<p>So, our research supports the idea that suicide risk should be assessed independently of – and in addition to – depression and anxiety among pregnant women.</p>
<h2>Broader focus needed</h2>
<p>This is an important nuance. Suicide prevention initiatives have traditionally focused narrowly on identifying and treating psychiatric illness. Our findings suggest they should more broadly include interventions that tackle socioeconomic factors and adversity.</p>
<p>Interventions that focus exclusively on psychiatric determinants of suicidal behaviour are unlikely to be effective. This is especially true in low-resource settings. Contributing factors include a scarcity of mental health resources and factors that adversely affect people’s lives.</p>
<p>More work still needs to be done to identify effective suicide prevention interventions for pregnant women living in adverse conditions. This requires more collaboration between different sectors. Policymakers also need to tackle social ills and find ways to increase the level of support for pregnant women and mothers of young babies.</p><img src="https://counter.theconversation.com/content/71286/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jason Bantjes receives funding from the South African National Research Foundation and the South African Medical Research Council. </span></em></p><p class="fine-print"><em><span>Nnachebe Michael Onah receives funding from University of Waterloo and multilateral organisations. </span></em></p><p class="fine-print"><em><span>Simone Honikman receives funding from philanthropic organisations and trusts, the University of Cape Town, The Medical Research Council (SA), DFID (UK)</span></em></p><p class="fine-print"><em><span>Sally Field does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Depression may lead pregnant women to engage in suicidal behaviour. But the socioeconomic contexts pregnant women are in may also contribute to their suicide risk.Jason Bantjes, Senior Lecturer in the Psychology Department, Stellenbosch UniversityNnachebe Michael Onah, Doctoral Candidate, University of WaterlooSally Field, Project co-ordinator: Perinatal Mental Health Project, researcher, University of Cape TownSimone Honikman, Director of the Perinatal Mental Health Project; Senior researcher, University of Cape TownLicensed as Creative Commons – attribution, no derivatives.