Intended for healthcare professionals


A prescription for poverty

BMJ 2016; 353 doi: (Published 20 June 2016) Cite this as: BMJ 2016;353:i3370
  1. Jane Parry, freelance journalist, Hong Kong
  1. jane{at}

Jane Parry reports on a family physician run project in Canada that aims to treat social problems as well as medical ones

It’s a predicament familiar to any doctor with patients who are living in poverty: you can treat a patient’s medical condition but the underlying reasons why the patient has poor health—low paid work, poor housing, low literacy—are beyond the scope of the prescription pad.

Gary Bloch, a family physician at a St Michael’s Hospital clinic situated in a socially deprived area of downtown Toronto, Canada, wanted to do more than just feel powerless about his patients’ situation. So he decided to learn about the effect of poverty on health and equip himself and his colleagues with the tools to do something about it.

In 2005 he took part in an eight month series of clinics organised by the Ontario Coalition Against Poverty. Bloch was one of 40 health practitioners at the organisation’s “hunger clinic,” held in front of the provincial legislature, who helped 1000 people living on welfare obtain a special diet supplement of up to $C250 (£134; €170; $190) a month.1 He was, in effect, prescribing them money to treat their food insecurity. The province tightened the criteria for the allowance soon afterwards, but it showed Bloch that doctors could take action to tackle poverty and gave him a taste for more. …

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