Edmonton Vital Signs is an annual check-up conducted by Edmonton Community Foundation, in partnership with Edmonton Social Planning Council, to measure how the community is doing. We also focus on individual issues, Vital Topics, that are timely and important to Edmonton.
This Vital Signs report provides a birds-eye view of how Edmontonians are making ends meet.
In Alberta, child care is generally regulated by both provincial and federal governments, and rarely by the municipalities in which the facilities are located. Issues around child care often cannot be addressed by municipalities, such as long wait-lists, lack of coverage, affordability, and impacts from COVID-19. As a result, many cities struggle with ensuring access to early learning and care.” In this blog post we will explore the issue of child care coverage, some of the impacts that COVID-19 has had on the child care system, and what a few municipalities in Alberta can teach us when it comes to providing quality child care.
Figure 1 Source — Canadian Centre for Policy Alternatives, Child Care Deserts in Canada.
In Edmonton, as in the rest of Canada, child care can be a major struggle for parents. There are many factors that make it a challenge, including availability and affordability. In Edmonton, estimates for child care coverage range from 3 to 3.7 spaces per 10 children under four years old [1, 2]. While there has been an increase in child care coverage in past years, coverage is not evenly distributed across Edmonton [3]. In Alberta, coverage sits at just 36% for all children in the province, with Calgary and Edmonton contributing a combined coverage of 43% despite housing over half of all children in the province [4]. However, even within Edmonton, 33% of children live in a child care desert. We can see from these numbers that long wait-lists have been the norm and are not simply an outcome of the pandemic.
The child care system has been greatly affected by the COVID-19 pandemic. Though this topic deserves its own separate analysis, here are a few key facts:
LOSS OF CHILD CARE WORKFORCE: In Alberta’s first wave, 55% of centres reported mass staff layoffs [5]. In the first year of the pandemic, Alberta lost 20% of its child care workforce—from 18,818 licensed educators in March 2020, to 14,984 in March 2021 [6].
INCREASE IN FEES: The Canadian Centre for Policy Alternatives (CCPA) annual report shows that fees for preschool-aged children rose in several large cities in the country as a direct result of COVID-19. These increases ranged from +1% to +25%; Edmonton faced fee hikes of over 6% [6].
DROP IN CHILD CARE ENROLLMENT: With the rise in cost there was also a decrease in enrollment rates [6]. This created a problem for facilities struggling financially throughout reopening efforts. Between February and September 2020, there was a drop of 43% in child care enrollment in Edmonton (about 10,000 spots). The CCPA report draws a strong negative correlation between declining enrollment and high fees.
At first glance, the pandemic created major challenges in child care. On closer inspection, it simply brought out the fragility of the system. COVID-19 has highlighted the feedback loop of a dwindling workforce that results in higher fees, causing parents to refrain from enrolling their children in programs [7], causing more staff to be laid off—and the cycle continues. David Macdonald, CCPA report co-author, broadly noted, “relying on exorbitant parent fees to fund services that should be part of the social infrastructure is what got us into this mess in the first place” [8].
So how can communities address child care affordability and accessibility? Fee issues will be easier to fix than availability/ accessibility. We’ve seen that when provincial and federal governments commit to subsidizing child care (such as with the $25/day or $10/day programs, discussed in a previous post on child care in Alberta), options are made available to low-income families. However, improved affordability means that wait-lists often skyrocket [9]. Making child care affordable but neglecting to address the number of licensed facilities does not actually get more children into care. Even in provinces like Quebec and P.E.I., where fees are set and capped, child care accessibility depends heavily on where parents live. Finding child care in large urban areas tends to be easier than in rural areas [4].
It’s not only a matter of making the system affordable, but also creating initiatives to increase the number of licensed early learning and child care spaces where needed [4]. If municipalities had a major role in child care, would that help deal with the ongoing issue of child care deserts? Currently in Alberta there are four municipalities that are involved in supporting child care: Jasper, Beaumont, Drayton Valley, and the Municipal District of Opportunity No. 17 (located north of Edmonton). Beaumont has a fixed budget to cover about 20% of their child care program, while the other three areas have established annual budgets to support their programs [10]. Additionally, public support in these communities has several benefits:
Fees are lower than the provincial average for similar level of care, despite the remote locations.
Services remain affordable for local families.
Specific needs of the community can be targeted.
Physical sites are developed purposefully for early learning and care.
Closer to home, the Edmonton Council for Early Learning and Care has made several recommendations in support of better early learning and child care (ELCC) [11]. To ensure child care services remain responsive to local needs and priorities, one recommendation is to support provincial system-wide planning through regional service management. When local communities have the power to plan and manage their child care services, they are better able to provide those services where needed. An example of this exists in Ontario, where 47 municipal governments are responsible for planning and managing licensed child care services at the local level [12]. They partner with schools to provide full-day kindergarten programs for all 4- to 5-year-old children. Despite being non-compulsory, most Ontarian children are enrolled in one of these programs.
Ontario’s model suggests that having municipalities involved in delivering child care is an achievable goal. Bigger cities, such as Edmonton, could benefit from getting municipalities and schools involved, as the city would have better control over accommodating local needs and vulnerable sectors, thereby making it easier to target areas at risk of child care deserts. Likewise, the four Alberta municipalities mentioned demonstrate that it is possible to provide child care in communities that are not able to support and sustain child care through a market model. Areas where child care services tend to have higher costs, such as small, isolated communities or communities with special cultural and social needs, could also benefit from having similar child care programs run by their municipality to provide better options for parents.
Municipally managed child care is not free from challenges. Currently, Albertan municipalities have no legislated obligation to play a role in funding, planning, or managing child care services. As such, any municipality that wishes to contribute to their local child care must justify expenditures for these programs during times of financial difficulty (such as the current pandemic). Provincial and federal support for regionally managed ELCC programs would go a long way towards easing that burden and providing communities with improved child care options. This is a worthwhile goal to achieve, as that support goes back to the community—for every dollar spent on child care, the general economy receives between $1.50 and $2.80 in return [13].
Luis Murcia is a volunteer with ESPC. His goal and passion is the pursuit of knowledge for the betterment of society. In 2013, he came to the University of Alberta from El Salvador and graduated with a BA in psychology and a minor in philosophy. He is striving to develop into a person that can help others become their best self.
Macdonald, D., & Friendly, M. (2021). Sounding the alarm: COVID-19’s impact on Canada’s precarious child care sector. Canadian Centre for Policy Alternatives. https://www.policyalternatives.ca/TheAlarm
The ongoing pandemic has brought to the fore the abysmal state of institutional long-term care (LTC) in Canada. As evidenced by the devastation, the existing system will not suffice and will certainly not hold against the advancing wave of aging Canadians. While a complete overhaul of institutional care is necessary, increasing support for both formal homecare and informal caregiving could facilitate the preference for aging-in-place at home. At present, however, with limited access to a fragmented and often confusing home care system, insufficient alternatives can lead to inappropriate institutionalization. The report Assessing Cash-for-Care Benefits to Support Aging at Home in Canada, based on a study conducted by the Institute for Public Policy as a part of their Faces of Aging research program, examines popular cash-for-care benefit programs in Germany and the Netherlands as a possible solution for expanding care options to better support aging at home in Canada.
While several Canadian provinces have self-managed home care programs, most restrict choice by precluding informal caregiving arrangements. This negates important advantages of cash-for-care benefit programs like those currently operating in both Germany and the Netherlands. Cash benefits can increase autonomy by allowing financial compensation to informal caregivers, decreasing cost by substituting for institutional care, and redistributing the burden on informal caregivers by affording the means to engage supplemental care. Though an appealing option with demonstrable successes, a deeper examination also reveals shortcomings to consider.
Lessons from both Germany and the Netherlands must be contemplated if a Canadian cash-for-care program is meant to alleviate cost of the more expensive formal and institutional systems. Flexibility of programs in both Germany and the Netherlands have resulted in higher uptake and hence greater public spending as a result of payment to informal caregivers, such as family members, for the same previously uncompensated work. Since this mounting financial cost has not significantly increased quality or provision of care, both countries have instituted more restrictive measures, including significantly lower payment amounts offered for informal care than formal care.
At the same time, establishing a Canadian cash-benefits policy would require acknowledgement of persistent societal norms regarding gender and caregiving, which continue to disadvantage women. Unpaid informal caregiving responsibilities exhibit a detrimental effect on work hours and earning capacity. Cash-benefit considerations must include financial support such as vacation time and pension contributions to properly alleviate the long-term, and often life-long consequences that still disproportionately affect female caregivers.
The German program has given rise to a large, unregulated, and untrained “grey market”—with families using cash benefits to hire migrant workers to provide 24-hour care that would not otherwise be possible or affordable. Ungoverned by social or labour regulations, studies have revealed exploitative practices and intolerable working conditions (p. 17). In the Netherlands, on the other hand, program constraints and well-funded formal home care services paid for with universal, mandatory LTC insurance plans have instead led to a highly regulated care market. Canada’s own Live-In Caregiver Program (LCP) would likely become more popular if cash benefits were introduced. Already having required changes to combat similar issues, the LCP program would necessitate further restructuring to protect vulnerable workers.
With a rising reliance on informal care, quality is at issue. Monitoring is difficult and enforcing standards, disciplining, or terminating informal caregivers—especially relatives—is nearly impossible. Instead, to prevent the potential for senior abuse and ensure quality and safety, cash benefits must be tied to a minimum level of training, with clear delineation of tasks appropriate to informal caregivers or to care professionals.
With an estimated 120% increase of older adults requiring LTC supports by 2050 (p. 7), in addition to an immediate overhaul of the current system, capacity building strategies to enable older adults to remain in the home must be urgently pursued. While some success has been recognized with cash-for-care benefit programs in Germany and the Netherlands, Canada can learn from both. The failure of either program to reduce costs, alongside difficulties ensuring quality of care and struggles to overcome long-term consequences for women and exploitation of grey market caregivers, demonstrate the need for a strong, formal caregiving system and proper supports for informal caregivers. Especially when considering a Canadian version of a cash-for-benefits program.
Publication Source:
Flood, C. M., DeJean, D., Frisina Doetter, L., Quesnel-Vallée, A., & Schut, E. (2021). Assessing
Shawna Ladouceur is a Registered Nurse who sees the impacts of the social determinants of health in ways that demand action. She has extensive experience working directly with vulnerable populations in the inner city. Her personal interests include skiing, hiking, biking, running, reading, and travelling
Calls to change how the non-profit community functions have existed at the fringes of the sector for decades. However, COVID-19 has rapidly revealed historical injustices within the sector, bringing calls for change to the forefront. In response, many leaders have answered these emerging needs by spearheading transformative initiatives. One such example is this report, taken on by the Edmonton Chamber of Voluntary Organizations (ECVO). The report, Transforming the Non-Profit Community in Edmonton, is described by the ECVO as the first phase on a long road to bring to life “a reimagining of non-profits” within a local Edmonton context (p. 1). The report captures historical injustices magnified by COVID-19 while harnessing their impacts to imagine a desired future that transcends the current status quo. The report opens with a review of the non-profit sector—past and present, includes surveys, myths, and trends, and introduces a model for change. The information is based on 24 individual and five group conversations held with 82 Edmonton-based knowledge holders (p. 13). The collaborative approach aimed to increase critical reflection, system-wide connectivity, and community accountability by creating opportunities for engagement and generous critique for/by those working first-hand in the sector.
Three main categories were brought to the forefront during the reporting process: myths, trends, and a model for change. As seen by sector insiders, myths are widely held yet largely inaccurate beliefs that often create barriers in practice and policy. Myths highlighted include:
The non-profit sector is truly voluntary,
Non-profit organizations are flexible and responsive,
Non-profit organizations operate as representatives of the community,
The non-profit sector is apolitical,
non-profit programs are fully data-driven and evidence-based, and
The non-profit sector is truly altruistic. (p. 14)
In tandem with myths, trends—or general patterns—often emerge from neoliberalism and have also marked how the sector operates. Trends emphasized in the report include:
Short-term, contract-based funding,
Venture philanthropy,
“Business-like” practices,
The organization as the primary unit of analysis,
Outdated board structures, and
Individualized programming of subsectors. (p. 20)
Using these myths and trends as guideposts, ECVO present a model for change that encapsulates a more socially just future for the non-profit sector. Inspired by the Miami Workers Center, ECVO’s model for change offers four pillars of action: service, power, consciousness, and policy (p. 24). At first glance, the pillars appear ambiguous and broad. However, each pillar is broken down to address explicit concerns. Some examples include:
Switching from a 3- to 5-year planning cycle to a 50- to 100-year vision,
De-centring organization,
Hiring those directly impacted by systemic harms,
Building social justice competencies,
Building new knowledge systems into decision-making processes, and
Funding more significant advocacy efforts. (p. 25–37)
While each pillar is thorough and specific in its mandates, as a whole, the model begs questions of infrastructure. In any such work, how does one “devise methods of participation and decision-making, build and sustain leadership, create shared political analysis, and generate and manage resources to feed the work”? (p. 38)
ECVO preface their work by stating it is not prescriptive, nor complete. They emphasize that they do not support or oppose political parties but instead focus on how past practices and policies have shaped current operations. This non-partisan approach, along with the ECVO’s innovative, collective, and collaborative process, seems to be both reflective and flexible. As stressed in the report, this is merely phase one. As the process unfolds, more insight is gleaned and new learnings emerge and so priorities may shift. But for now, the ECVO report appears to be a comprehensive and critical step for a more socially just future for the sector. As such, they encourage readers to take their report and “use it to build new forms and methods of participation, decision making, leadership, and resource distribution. It is by altering our everyday processes that we can build new infrastructure and in doing so, construct alternative futures” (p. 38).
Rebecca Jansen is currently a graduate student at the University of Alberta studying educational policy specializing in Adult, Community and Higher Education. With over ten years of experience as an adult and community educator, her primary research focus is on embodied learning, indigenization, and policy reform to realign power imbalances within social institutions that impact local communities.
The Royal Society of Canada established its Task Force on COVID-19 in April 2020 to “provide evidence-informed perspectives on major scientific challenges in response to and recovery from COVID-19” (p. 2). The result of the task force’s findings is Impacts of COVID-19 in Racialized Communities, a collection of eleven essays published in May 2021.
Racism existed before COVID-19. The pandemic simply created conditions in which racism became more apparent. The attitudes, policies, and practices created and reinforced by individual, systemic, and cultural racism resulted in disparities that could no longer be ignored by mainstream society. In the anthology’s introductory essay, “The Background to Racism in Canadian Society,” author Frances Henry explains: “It is the racism that existed in settler societies, the racism that led to the subjugation of people through colonialism and the expansion of Europeans into far off places in the world, which created the conditions that exist today” (p. 14). COVID-19 became a racial issue when the historical roots of racism, colonialism, and imperialism created unequal conditions among people living in Canada.
Canada has never really collected race-based data related to the COVID-19 pandemic. Certain provinces, such as Manitoba and Ontario, started to collect this data recently—though only in clusters (p. 25). The result is that Canadians cannot accurately determine the impact that COVID-19 has had on different racial communities. However, just because we cannot determine how people of colour were affected does not negate the irrefutable fact that visible minorities were far more affected by the virus than white communities.
Take, for example, the data that the City of Toronto gathered throughout the pandemic: “In the Greater Toronto Area, whites account for 48 per cent of the population and 17 per cent of COVID-19 cases. This is in contrast to the situation with Black people who account for 9 per cent of the population and 21 per cent of cases” (p. 19). This data supports emerging statistics from the United States, which project that 1 in 1,125 Black Americans have died from COVID-19 compared to 1 in 2,450 White Americans (p. 25). Similar numbers collected from the United Kingdom also highlight the stark differences between rates for people of colour who are affected and dying from COVID-19 in comparison to white populations in the same areas.
The virus does not discriminate. Poor conditions grounded in centuries of systemic racism have worsened the impact of COVID-19 on certain groups. In addition to sickness, racialized communities have also had to deal with economic and social factors that cause uncertainty and instability in an already turbulent time. In the essay “Racial Inequality, COVID-19 and the Education of Black and Other Marginalized Students,” Carl E. James identifies the factors that contribute to inequality as access—or lack thereof—to nutrition, academic supports, mental health, and online learning (p. 30). People who face multiple barriers when accessing these resources are more likely impacted by the long-term health and social effects of COVID-19.
Source: The Canadian Medical Association
Health care experts have criticized the federal government’s decision not to collect race-based data during COVID-19. Many consider this decision a failure to provide support for marginalized communities and indicative of a flawed system built upon colonialism. In the essay “Race and Ethnicity Collection During COVID-19 in Canada: If You Are Not Counted You Cannot Count on the Pandemic Response,” Kwame McKenzie goes so far as to say that “seeing significant disparities and doing nothing active to deal with them is a form of systemic racism” (p. 67). The federal government’s silence on the issue does not hide the obvious harm that has already been inflicted by centuries of colonial policies that have prevented visible minorities from accessing necessary health and education resources or inhabiting clean, socially distanced spaces that increase quality of life.
Overall, the report’s primary recommendation is to begin collecting race-based data and to involve racialized communities in the collection and dissemination of the information. While this solution does not amend all of the damage that COVID-19, and other health crises, have already done, it is a step forward into a post-COVID and, more importantly, post-colonial nation. Having diverse voices at the table means that government decisions would no longer be made based on archaic legislation that—either intentionally or unintentionally—excluded and discriminated against minorities.
Although rebuilding in a post-COVID landscape is uncertain, it is also an opportunity to lay a new foundation that is informed by the mistakes made in the past. Re-examining the systems, institutions, and attitudes that have created unequal access to health care and other resources means people living in Canada can prevent history from repeating and begin a precedent for neighbouring nations.
Jayme Wong graduated from the University of Lethbridge in 2014 with a BA in English and Philosophy, and more recently graduated from the University of Alberta in 2020 with an MA in English and Film Studies. She currently works at a local non-profit, the Learning Centre Literacy Association.
At the beginning of 2020, the COVID-19 pandemic—arguably the biggest public health crisis of our time—transformed the prospects of Alberta’s economic climate. In response to these historic events, the government responded with surplus funding to meet public health mandates including mobilizing efforts to purchase protective personal equipment, fund emergency isolation procedures and precautions, and ensure health care facilities were adequately supplied with equipment and staff to manage the uptake of COVID-19 related precautions, procedures, and patient admissions. In total, the Alberta government reportedly allocated $5.8 billion to the COVID-19 response in 2020. It is now 2021, and the provincial vaccination program has placed a considerable damper on the surge of COVID-19 cases, which proceeds the government’s economic recovery plan: aggressive cuts to social sectors including health care and public services in an effort to reduce the estimated $18.2 billion provincial deficit for 2021–2022.
However, the pandemic is not exclusively responsible for the economic turmoil that Alberta is currently in. Alberta has had deficits in the past: $12.2 billion in 2019–2020, $20.2 billion in 2020–2021, followed by our current estimated deficit of $18.2 billion (see Figure 1). What does this mean for Albertans? A growing deficit and debt mean that more tax dollars are spent on paying back interest. According to the 2019 Report and Recommendations by the Blue Ribbon Panel on Alberta’s Finances (also known as the MacKinnon Report), if present trends continue, the government will spend an estimated 5.9% of its budget on interest in 2022–2023, which can translate to the cost of more than 30,000 teachers or 35,000 long-term care beds. The 2021 Budget Highlights released by the City of Edmonton estimates that 10.1% of municipal tax dollars go straight into debt repayment. In response to these alarming numbers, the government’s agenda to cut costs is justified, but may be executed in an inefficient manner by cutting costs in all the wrong areas.
Figure 1: source, Government of Alberta
The Problem with Alberta’s Health Care System
Prior to the pandemic, the Blue Ribbon Panel, an independent group of finance experts, examined government spending and recommended areas for savings. Though controversial, the panel’s report produced 26 recommendations to reduce costs based on previous budget spending. The report thoroughly detailed health care spending in Alberta, as health care costs make up 42% of Alberta’s current budget. Alberta spends more money on health care costs per capita compared to other provinces, as displayed in Figure 2.
Figure 2: source, Canadian Institute for Health Information
In Alberta, a standard hospital stay per person is estimated to average around $7,992, compared to the national average at $6,349. The McKinnon Report noted that longer and costlier hospital stays can be attributed to a shortage of alternative care options (i.e., primary care clinics) and increased barriers to discharge and support service resources. The panel recommended that the government “make greater use of alternative service delivery for day procedures and other services that do not have to be delivered in hospitals” (MacKinnon Report, p. 33). In response, the government enforced the Alberta Health Care Insurance Amendment Act under Bill 30 in July 2020. A notable highlight of Bill 30 introduces private contractors in the public health care system, creating a two-tiered health care system. This would allow for-profit corporations to bill the government directly, which could drive up costs to health care. The Parkland Institute reports that although privatization could arguably gratify cost-cutting measures in short term settings, a two-tiered health care system would “set the stage for eroded pay and working conditions, infrastructure gaps, and inequitable access to health care” which increases long-term systemic issues in access and quality of health care (Privatization Pressures in Alberta Health Care, p. 35).
Short-Term Cuts: Not Sustainable to Fix the Problem
The cuts to Alberta’s health care and social sectors all share a common theme: short-term potential and a lack of commitment to the long-term prosperity for Albertans. Cutting corners on costs such as COVID-19 related public health measures, cutting nursing wages, and closing valuable social services (such as safe consumption sites) simply act more as short-term “Band-Aid” solutions that will send this province into further financial burden. In addition, cutting back on public health measures, such as reduced COVID-19 testing services and isolation requirements, will only burden the health care system in the long-run. Thus, investing in public health measures and investing in social services that are committed to vulnerable populations (i.e., those struggling with poverty, addictions, and/or homelessness) is of value in long-term cost saving measures. Cuts to essential social services that are often preventative in nature will worsen the health outcomes and well-being of vulnerable communities, which will translate into increased costs in primary acute care services.
Moving Forward
There is no question that Alberta’s current economic landscape requires significant spending cuts, concurrent alongside diversification in revenue sources to ensure future prosperity for Albertans. To see that Alberta’s fiscal concerns are addressed, the government must collaborate with public health experts to promote sustainable actions and that won’t jeopardize Alberta health care services.
About Sung Min (Amy) Jo
Sung Min (Amy) Jo is a nursing student at the University of Alberta. Following previous work experience with community non-profits, she is excited to pursue a career in public health pertaining to policy and program development in response to barriers experienced by vulnerable/marginalized communities. She is currently working with ESPC in a student placement through Canada Summer Jobs.
