NBA star Tyrese Haliburton was recently diagnosed with shingles. The news drew attention to an illness that many people rarely talk about but is far more common than many realize.

In Canada, 130,000 people develop shingles each year. The infection can cause a painful rash and, for some, long-lasting pain that can affect their quality of life for months.

Yet shingles cases are also largely preventable through vaccination. Despite the availability of a highly effective vaccine, fewer than four in 10 Canadian adults aged 50 and older report having received the shingles vaccine.

As researchers focused on aging and vaccination at Toronto Metropolitan University’s National Institute on Ageing, we study vaccine-preventable diseases, vaccination policies and opportunities to improve prevention in Canada.

What is shingles?

Shingles, also known as herpes zoster, is an infection that typically appears as a painful rash with blisters. The virus responsible for shingles is the same virus that causes chickenpox.

After a chickenpox infection, the virus remains in the body and can reactivate when the immune system weakens due to aging, health conditions or certain treatments. People who received the chickenpox vaccine can also develop shingles, but the risk is much lower.

Symptoms often begin with itching, tingling or pain, followed by a rash that usually appears as a strip on one side of the body, most commonly on the torso. In some cases, the rash can appear on the face.

While the rash typically clears within a few weeks, shingles can lead to serious complications. The most common is post-herpetic neuralgia, pain that lasts more than 90 days and can affect daily activities.

If shingles affects the eye and surrounding area, it can cause scarring and vision loss.

Antiviral medications can reduce symptoms, but they are most effective when started within 72 hours of the rash appearing.

Who is most at risk?

As shingles often occurs when the immune system weakens, the risk increases with age and certain medical conditions.

More than two-thirds of shingles cases occur in adults older than 50, and incidence rises with advancing age.

People who are immuno-compromised, meaning their immune systems are weakened by disease or treatment, are at higher risk. This includes those with conditions such as autoimmune diseases, cancer, human immunodeficiency virus (HIV) and those who have undergone transplants.

Chronic conditions like asthma, diabetes, cardiovascular disease and chronic obstructive pulmonary disease (COPD) have also been associated with higher shingles incidence.

For many people with these conditions, shingles infections may be more severe, with a greater risk of complications.

The shingles vaccine

There is currently one shingles vaccine available in Canada: Shingrix (generic name non-live zoster vaccine recombinant, adjuvanted), which is given in two doses.

Clinical trials have consistently shown this vaccine provides strong protection against shingles and its complications across multiple populations, with 97 per cent effectiveness against shingles among immuno-competent adults aged 50 and older over three years. The vaccine has also been found to be generally well tolerated among immuno-competent adults aged 50 and older and immuno-compromised adults aged 18 and older.

Recent research shows the vaccine remains highly effective even in the 11th year after vaccination, with 82 per cent effectiveness against shingles among immuno-competent adults aged 50 and older.

Canada’s National Advisory Committee on Immunization (NACI) strongly recommends Shingrix for adults aged 50 and older, including those who previously received the earlier shingles vaccine (Zostavax, generic name zoster vaccine live) or who have had shingles. NACI also strongly recommends Shingrix for immuno-compromised adults aged 18 and older.

The second dose of Shingrix is recommended two to six months after the first dose. For immuno-compromised adults, however, the second dose can be administered at least four weeks after the first dose.

Vaccine coverage remains low in Canada

Despite strong recommendations and a highly effective vaccine, shingles vaccination rates remain relatively low in Canada.

As of 2023, only 38 per cent of adults aged 50 and older reported having received at least one dose of the shingles vaccine. In some provinces and territories, vaccination rates are even lower, falling to around 25 per cent.

One reason is that public coverage for the shingles vaccine varies widely across Canada. Currently, eight of Canada’s 13 provinces and territories provide some level of public coverage for Shingrix, often limited to specific age groups or high-risk populations.

Only Prince Edward Island and Newfoundland and Labrador provide coverage for all adults aged 50 and older. Newfoundland and Labrador also covers immuno-compromised adults aged 18 and older.

The post What to know about shingles, a painful infection that vaccination can prevent appeared first on TMU Research & Innovation Blog.

Many Canadians say they care about ethical products. They want coffee that supports farmers, chocolate made without child labour and everyday goods that are better for the environment.

Many also say they are willing to pay more for ethically produced goods. Yet those values often fade once people are standing in front of a shelf of seemingly identical products.

This gap between what consumers say they value and what they actually buy is often described as hypocrisy. That explanation is tempting, but it misses something important. In most shopping situations, people are not choosing between right and wrong — they are choosing between prices.

That tension has become harder to ignore as food prices in Canada have risen sharply, squeezing household budgets and making cost the dominant concern in everyday decisions.

At the same time, Canadians continue to express concern for sustainability and ethical production. Caring has not disappeared. Acting on it simply feels harder now.

When good intentions meet the checkout

Consumer research has long documented a gap between stated preferences and actual behaviour. In surveys, people tend to express stronger ethical intentions than they act on in real shopping situations. That does not mean those values are insincere, but that values are pushed aside when everyday constraints take over.

This gap shows up most clearly in routine purchases like groceries, coffee and chocolate. These are items people buy often, and even small price differences add up quickly. In those moments, price becomes the easiest decision shortcut, especially as food costs continue to rise in Canada.

Ethical products usually cost more because they support higher wages, safer working conditions and lower environmental harm. While those benefits matter socially, they don’t directly benefit the person paying at the checkout.

As household budgets tighten, choosing the ethical option can start to feel less like a moral decision and more like a financial burden.

Rethinking the ethical premium

Much of the debate around ethical consumption assumes that supporting better practices necessarily requires paying more. Ethical products are often framed as “premium” goods, with higher prices justified by their social or environmental benefits.

In our recent research study, we asked whether the ethical premium always had to be paid in money. Instead of focusing on higher prices, we examined whether consumers would respond differently if ethical products were offered at the same price as conventional ones, but in smaller quantities.

To explore this, we ran a series of experiments with more than 2,300 participants in Canada, the United States and Europe. Participants were asked to choose between ethical options (such as Fair Trade or sustainably produced goods) and conventional alternatives for everyday products like coffee and soap.

Participants were then randomly assigned to conditions that framed the ethical premium either through price or quantity. In the price-premium condition, participants chose between a higher-priced ethical option and a conventional alternative of the same quantity. In the quantity-premium condition, the ethical option was offered at the same price as the conventional alternative, but in a smaller quantity.

Across our experiments, consumers were consistently more likely to choose ethical products when the premium was framed as giving up quantity rather than paying a higher price.

Choosing less instead of paying more

Across our experiments, people reacted more strongly to price increases than to size changes. Consumers are more sensitive to price information than quantity information.

When ethical products cost the same as conventional ones, consumers no longer feel financially penalized for acting on their values. Rather, paying the premium with quantity makes the ethical product feels more affordable.

Importantly, this approach is not the same as shrinkflation, where companies quietly reduce package sizes over time without informing consumers. In our studies, the smaller size was explicitly visible, and consumers knew exactly what they were choosing.

Making ethical choices affordable

With grocery prices remaining high in Canada, expecting consumers to close the ethical gap by paying more money may be unrealistic. Ethical consumption does not fail because consumers are indifferent or hypocrites.

It fails because ethical choices are often presented in ways that make them feel financially out of reach.

Rethinking how the ethical premium is paid will not solve the problem overnight. Structural issues, such as supply chains, corporate practices and regulation, still matter deeply. But our findings suggest that design choices and pricing strategies can make a meaningful difference in whether consumers are able to act on their values.

If ethical consumption is to become more than an aspiration, it may need to be integrated into everyday affordability rather than positioned as an added cost. How we ask consumers to support ethical practices matters more than we often assume.

The post Why people say they care about ethical shopping but often buy differently appeared first on TMU Research & Innovation Blog.

Home care providers in Ontario, who are disproportionately racialized immigrant women, experience precarious working conditions. And their labour remains invisible to many. (Unsplash)

Despite recent provincial investments, Ontario’s home-care system is still in crisis. Underfunding, rationed care and ideological preferences for privatization of services undermine dignified aging and care for those in need of support at home.

At the same time, home-care providers, who are disproportionately racialized immigrant women, experience precarious, exploitative and sometimes dangerous working conditions.

My newly released research report, entitled “Caring about Care Workers: Centring Immigrant Women Personal Support Workers in Toronto’s Home Care Sector,” is a collaboration with Social Planning Toronto(SPT), a non-profit, community-based agency. In it, we highlight the concerns and preferences of these undervalued workers.

Our report presents data from interviews with 25 immigrant women working as personal support workers (PSWs) in home care in the City of Toronto. Our conversations, conducted between 2023 and 2025, focused on employment conditions and workplace safety, the critical need for systems change and the possibilities for building PSW collective power.

A vital service held together by precarious labour

Home care provides crucial supports to seniors who want to live in their own homes longer, facilitates the autonomy of people with disabilities and aids in the recovery of individuals following a hospital stay.

Their work both supports widespread client preferences to “age in place” and reduces pressure on hospitals and emergency departments. Yet it is routinely neglected and chronically under-resourced.

PSWs provide the majority of home care services. In 2022, an estimated 28,854 individuals were employed as PSWs in the home-care sector in Ontario. Home-care PSWs collectively provided 36.7 million hours of care to Ontario residents in 2023-24 through the provincially funded system.

Immigrant and racialized women comprise the majority of home care PSWs in the Greater Toronto Area. Home-care PSW labour is characterized by low wages, lack of employment benefits, health and safety risks and unique challenges associated with working alone in private homes.

Among PSWs in Ontario, those working in the home and community care sector have the lowest average wage, making about 21 per cent less on average than PSWs working in hospitals and 17 per cent less than those in long-term care. Inadequate provincial funding and inequitable and restrictive funding arrangements are the primary drivers that create and exacerbate these unacceptable conditions.

PSWs are absorbing the real cost of care

Our research participants explained how the normal costs associated with providing home care are offloaded onto them in several ways.

First, most PSWs in home care provide personal care to multiple clients each day. Travel between client homes is a requirement of their work. Yet participants shared that they either receive low pay or no pay for travel time between client homes.

One of our participants, Kemi, explained how travel time works in her agency:

“The travel time that we are paid is one hour. If I’m working five hours, that’s six hours I’ll be paid. But the thing is that the travel time amount is not the same as your regular wage… travel time is paid some amount less.”

If it takes more than an hour a day to travel between client homes, Kemi does not receive any compensation for that additional time. Yet this is a reality for her on a regular basis.

Joy, another participant, noted that PSWs in her agency personally pay more than half of their transit costs:

“They give us $1.60 per travel, but the payment we give the TTC is $3.50. I requested the company to make it the same, or at least a free TTC pass for the month. But the employer said it wasn’t appropriate.”

At the same time, many PSWs have long gaps of unpaid time between client visits during their workday. These gaps in their workday result in a full-time shift but only part-time compensation, with many getting paid for only a few hours each day. The result is full time work for a part-time wage.

In addition, participants noted that PSWs can have their work hours and income reduced if their caseload is reduced. This occurs when a client dies, moves, enters hospital or long-term care, switches home care providers or no longer requires services.

Ann-Marie described the precariousness of working in home care:

“You know why the hours are not guaranteed? For instance, I have eight clients, and out of eight clients, I have three clients that passed away. That’s all my hours reduced until they able to find another client to fit into my schedule.”

Reform must start with fair working conditions

Our report provides detailed policy recommendations targeted to both levels of government, home-care service provider organizations, unions and the community sector.

In particular, we advocate for the creation of a comprehensive public non-profit home-care system where home care workers, Ontario residents receiving care and their families play a central role. Rather than continuing with a fee-for-service model, we recommend adopting a grant-based funding model to better support the full cost of care provision.

We also advocate for developing employment standards for home care PSWs and improvement of public transparency and accountability in home care through data collection and analysis, along with regular public reporting and independent research. And, finally, rather than continuing to allow large home-care companies to extract millions in profit, we want every public dollar to support high-quality care and good working conditions for home care workers.

For the good of everyone in Ontario, it’s essential that the provincial government take bold action to reform the home-care system. The very least we can do for these essential and valuable workers is to ensure fair compensation, guaranteed work hours and good working conditions.

The post Immigrant women care workers keep Ontario’s home care afloat under exploitative conditions appeared first on TMU Research & Innovation Blog.

Despite the benefits migrant grandparents provide, sponsored grandparents are consistently suspected of taking advantage of Canada’s health care and social welfare systems. (Jonathan Castaneda/Unsplash)

Immigration, Refugees and Citizenship Canada’s recent announcement that it’s accepting 10,000 sponsorship applications under the Parent and Grandparents Program (PGP) comes with an important caveat.

Due to persistent backlog, invitations will only be sent to the 17,860 potential sponsors who submitted an interest-to-sponsor application back in 2020.

While good news for some, it means yet another cycle of uncertainty for thousands of families who have waited years for the PGP to finally reopen.

Migrant families seek permanent reunification for reasons other than a desire to live with their parents and grandparents in the same country. Those reasons include a need for child-care support and a desire to care for their older family members as they age.

As international conventions dictate, families have a right to be together.

From permanent to temporary

Grandparents have been part of Canada’s formal “family class” pathway since 1976, but current policy favours spouses and dependent children. This makes reunification for extended family members difficult.

Grandparent admissions through the PGP have comprised around 25 per cent of total family class admissions for the past 10 years.

Unlike other family class categories, there is a predetermined cap on accepted PGP applications. The PGP has also undergone a series of program freezes to deal with an application backlog, the most recent announced in January 2025. The government’s latest update included no commitment to receive new interest-to-sponsor declarations.

As an alternative to the PGP, the government recommends the super visa, a multi-entry visa valid for up to 10 years. However, the super visa requires grandparents to reapply and meet medical inadmissibility rules every five years.

The super visa also places responsibility for financial and health care of grandparents entirely on the sponsoring children, sometimes with devastating consequences.

Most importantly, the super visa does not guarantee permanent residence upon expiration. Permanent grandparent reunification remains a lottery draw, at the mercy of sponsorship intake caps.

Celebrating, denigrating migrant grandparents

Our preliminary research on grandparent sponsorship explores how elected officials consider the place of migrant grandparents in Canadian society. We’ve so far found they regard permanent family class migration as “good for business” as it attracts economic migrants. At the same time, elected officials believe that certain dependants monopolize health and social safety nets.

Grandparents, in particular, are treated by governments as human liabilities who must be admitted “responsibly.”

Admitting grandparents to Canada is tied to their perceived ability to support their sponsors by performing unpaid domestic labour. Our research has found elected officials celebrate sponsored grandparents for the substantial unpaid care work they provide like meal preparation, child care and cleaning.

In a recent survey on grandparent sponsorship, sponsors describe the unpaid work conducted by grandparents as essential to their participation in the Canadian workforce.

Migrant grandparents are also positioned as providers of cultural care for their grandchildren. Our research draws attention to elected officials often invoking memories of their own migrant grandparents passing along languages, practices and values that shaped their unique cultural identities.

Despite the benefits migrant grandparents provide, sponsored grandparents are consistently suspected of taking advantage of Canada’s health care and social welfare systems. This is why the super visa is promoted as an alternative pathway.

Dependent on sponsors

Grandparents who come to Canada through the super visa are financially reliant on their sponsors. Even though the government recognizes that the number of sponsored grandparents applying for old age security is relatively small, treating migrant grandparents as economic burdens allows governments to justify caps and application pauses on PGP sponsorship.

Contrary to governments’ framing of the super visa as aligning with migrants’ families demands for temporary care, our research shows that grandparents often resort to humanitarian and compassionate applications to obtain permanent residence once their super visa has expired. In these cases, their ability to perform care work is further scrutinized.

In terms of grandparent sponsorship, care is largely understood as temporary and one-directional — in other words, migrant grandparents are welcomed when they provide care, but are seen as liabilities when they need care themselves.

Prioritizing the needs of migrant families

How do we reconcile government claims that family reunification is a “fundamental pillar of Canadian society” with the reality that permanent grandparent reunification remains difficult to obtain?

Intake announcements like the most recent one in July allow governments to celebrate permanent grandparent migration. At the same time, the inconsistency of the PGP and solutions like the super visa keep migrant grandparents in a state of legal, political and economic precarity.

With the Liberal government announcing cuts to family class admissions over the next three years, the impact of these changes on grandparent reunification warrants attention.

Rather than temporary reforms and routes, the government needs to consider structural changes to Canada’s family class pathway that focus on the needs and interests of families seeking permanent reunification.

The post Here’s why Canada’s parents and grandparents reunification program is problematic appeared first on TMU Research & Innovation Blog.

Children need pauses from cognitive effort, ideally involving unstructured play. Students play during recess on Lasqueti Island, B.C., in 2016. THE CANADIAN PRESS/Chad Hipolito

The Toronto Star recently reported on a Ministry of Education memo it obtained that asks boards for input into a new regulation that “would provide school boards with the ability to structure their school day schedules for students in kindergarten to Grade 6 (primary and junior divisions) based on local needs and to maximize student learning.”

The ministry mentions “new flexibility in the scheduling of recess and lunch — for example, schools may choose to offer one longer recess period in place of two shorter ones, while still providing a lunch break,” plus the 300 daily minutes of instructional time.

While the impact of the potential changes is unclear (especially as many boards already operate on a “balanced day model” that moved away from two recesses plus a lunch break to offer two breaks instead), the proposed changes — plus ministry concern with maximizing student learning — warrant discussion about the significant role of recess in all schools.

Recess supports learning

As researchers who have long studied the links between school environments and children’s well-being, we know that reducing or restructuring recess time can negatively impact learning and development.

Indeed, research consistently shows that recess plays a vital role in academic success, mental health and overall well-being.

Cognitive science tells us that young children need regular breaks from focused academic work. These breaks reduce mental fatigue, improve concentration and help children return to class refreshed and ready to learn.

Simply switching from mathematics to reading isn’t enough. What’s needed are genuine pauses from cognitive effort, ideally involving unstructured play.

The power of play

Recess offers a chance for unstructured play, something children do freely and joyfully. Play isn’t just fun, it’s essential to healthy brain development. Whether they’re running, building, imagining or exploring, play activates the brain’s reward systems, releasing endorphins that enhance mood and reduce stress.

Play is so fundamental to healthy development that the United Nations Convention on the Rights of the Child has long deemed it a basic human right, and as a signatory, Canada is obligated to uphold this right.

It’s important to note that gym class or other structured physical activities don’t offer the same benefits. Children need time to follow their own interests, move at their own pace and interact freely with peers.

Movement, the outdoors

Kids aren’t meant to sit still all day. Recess gives them a chance to move, whether that’s running, jumping or just walking and stretching. Regular movement improves circulation, boosts energy, supports mental clarity and improves mood. Even short bursts of physical activity can help offset the long hours spent sitting in classrooms.

Time outside can have meaningful effects. Nature has a calming effect on the brain, reduces anxiety and helps with attention and emotional regulation. Green spaces and natural materials like trees, grass and fresh air offer benefits that indoor classrooms simply can’t replicate.

Socializing, mental wellness

To children, recess isn’t just a break, it’s a vital social time. It’s when they form friendships, practise conflict resolution and feel a sense of belonging. These connections support emotional development and make school a place where kids want to be.

Unfortunately, as schools focus more on maximizing instructional minutes, this social time can be undervalued. But connection and belonging are not side benefits — they are essential to academic motivation, engagement and overall student success.

Physical activity, outdoor time, free play and meaningful social interaction all work together to support mental health and overall well-being.

Recess creates space for laughter, joy, relaxation and calm. Students who feel emotionally safe, happy and supported are more likely to pay attention in class, co-operate with peers and persist through academic challenges. In summary, healthy children are better learners.

Schools are more than instruction

Schools are communities where children spend much of their waking lives. They are places not only of academic growth but also social, emotional and physical development.

When schools prioritize student well-being, they are also strengthening learning outcomes. That’s why recess should not be treated as a filler or a luxury.

It’s a critical part of the school day and must be protected and well supported, not minimized.

Recommendations for recess

According to Physical and Health Education Canada’s National Position Paper on Recess, all students — from kindergarten through high school — should have regularly scheduled recess across the school day.

Children in kindergarten through Grade 2 should receive at least four 15-minute recesses daily, ideally outdoors. Children in grades 2 to 6 should have at least two 20-minute recesses, not including time spent putting on coats or lining up.

These are research-backed guidelines that support children’s full development. And, of course, the quality of recess matters, which is described further in the position paper.

The Ontario memo invites us all to revisit the role of recess in the school day. We must remember that time to play, move, connect and breathe is not a break from learning, it’s a vital part of learning.

The post Our kids’ recess at school is essential to well-being and learning — and shouldn’t be scaled back appeared first on TMU Research & Innovation Blog.

Nunavut has the highest rate of child poverty and the highest rate of food insecurity of any Canadian province or territory. In 2022, around 80 per cent of Indigenous children aged between one and 14 in Nunavut lived in households experiencing food insecurity. In 2018, the rate of childhood food insecurity in Nunavut was almost six times higher than in Canada as a whole.

The Hamlet Food Voucher Program, funded through the Inuit Child First Initiative (ICFI), has recently offered some relief. This program gives families funds for groceries to meet the nutritional needs of Inuit children.

However, ICFI funding only runs until March 31, 2025. With Parliament prorogued, plans for further funding remain uncertain. That means starting April 1, many Inuit children in Nunavut may again go hungry. The Canadian government can make sure that does not happen by extending funding for ICFI and the food voucher program.

Long-term effects of food insecurity

Food insecurity can have harmful, and sometimes lasting, impacts on a young person’s physical health, mental health, academic performance and cognitive development. Infants and toddlers are particularly vulnerable because they are completely dependent on adult caregivers whose physical and mental health can also be impacted by food insecurity.

Recently, food security initiatives in Nunavut have been funded through the ICFI, which was launched in 2018. ICFI was meant to be a temporary measure to help families access essential services while an Inuit-specific framework is being developed.

Nutrition support for children has been one of the most requested services under ICFI. Initially, each family had to submit extensive documentation, and often faced months-long delays before receiving services and supports.

In 2023, municipal governments in Nunavut began to request, and receive, ICFI funding for nutrition supports for all Inuit children in their community. By December 2024, all but one community received funding for Hamlet Food Voucher Programs. These programs provide $500 per child for groceries and an additional $250 for children under four.

High grocery costs

The support provided through the Hamlet Food Voucher Program is significant, but $500 covers far less in Nunavut than in southern Canada. Groceries must be brought to Nunavut by plane or ship, and most communities have only one or two grocery stores. Accordingly, despite efforts to reduce prices through programs like Nutrition North Canada (NNC), the cost of groceries in Nunavut is much higher than in the rest of Canada.

Grocery prices in Nunavut are also rising much faster than in the rest of Canada. Our research shows that, between 2022 and 2024, the cost of a basket of goods in Qikiqtaaluk, Nunavut’s largest region, rose by 26 per cent (compared to 13 per cent across Canada) and is now more than double the average cost in Canada.

Even food subsidized through NNC is far more expensive: four litres of milk cost $9.95 in Qikiqtaaluk compared to a Canada average of $5.10. Prices for other items can be even higher: a February 2025 video from the hamlet of Grise Fiord shows a jar of jam selling for $35, pickles for $66 and a six-pack of apple sauce for $58.

The high rate of food insecurity in Nunavut reflects a vast gap between household incomes and the money required to support a basic standard of living. Nunavut saw sustained income growth between 2005 and 2019, and a declining percentage of people receiving social assistance. Still, employment rates remain lower than in other territories.

In 2023, the median income for households with two adults and two children was just under $36,000.

This was around 40 per cent of the $89,420 needed for a two-adult, three-child family living in social housing in Iqaluit to afford the “modest, basic standard of living” represented by the official poverty threshold.

The social assistance available to low-income Nunavut families is comparable to that in provinces with a lower cost of living. Even with $1,000 a month in food vouchers, a family of four making the median income remains far below the “deep poverty” threshold of 75 per cent of the official poverty line.

An Inuit-led solution

We have been interviewing service providers, grocery store employees and people co-ordinating Hamlet Food Voucher Programs. The interviews are part of an ongoing research project we are working on in collaboration with Sindu Govindapillai and Dheeksha Reddy from Qupanuaq, a service co-ordination program operated by the Arctic Children and Youth Foundation, and research team members Kelly Mitchell, Mohammad N. Khan, Josee G. Lavoie and Tracey Galloway.

Interviewees tell us that, because of the program, fewer people go without food and more families can cover rent, utilities and other necessities. People also told us that families are eating healthier, children are going to school more often and are more engaged when there, and families are less stressed. Other programs and services that were previously busy addressing food-related crises can now focus on providing medical care, fostering learning and keeping children safe.

The people we interviewed also make it clear the Hamlet Food Voucher Program is not enough to solve the problem of food insecurity in Nunavut. They stressed that food security initiatives must be paired with supports for healing, well-being and life-long learning.

Inuit plans for addressing poverty include such supports. They also include measures to increase community decision-making, reform income assistance, increase access to housing and strengthen local economies.

Until such a framework is fully implemented, the Hamlet Food Voucher Program must remain in place. Nunavut families currently face record levels of child poverty, rising food prices and a potential North American trade war that would further drive-up costs.

Losing food voucher support would be catastrophic for many households, particularly those with young children. The Canadian government must support Inuit leaders working toward a long-term solution to food insecurity in Nunavut. By funding the Hamlet Food Voucher program in the interim, it can help ensure that the children of Nunavut do not go hungry.

The post Inuit children in Nunavut face a preventable food security crisis appeared first on TMU Research & Innovation Blog.

I teach a course on the relationship between social media and society at Durham College. As part of their assessments, I ask my students to reflect on their social media use.

A recurring theme is that they cannot be separated from their smartphones. Many admit to spending significant time daily on social media watching short videos without a clear purpose and as a way to procrastinate on more productive activities.

There is a term for this kind of behaviour and its impact on mental health, one that was recently named Oxford Word of the Year 2024: “brain rot” — the deterioration of a person’s mental or intellectual state, especially as the result of over-consuming trivial or unchallenging online content.

For many adults, a diffuse addiction to the internet, or what clinical psychologists call digital drugs (like online shopping, gaming, gambling, pornography), has become a widespread problem, especially since the lockdowns of the COVID-19 pandemic.

When social media platforms emerged at the beginning of this century, they were welcomed for their potential to empower individuals, facilitate storytelling and connect communities.

While they do enable these possibilities, they also pose significant challenges to our relationship with truth and trust — two pillars of a functioning democracy. By spreading misinformation and creating echo chambers that polarize communities, social media platforms have become a ground for the rise of “hate and extremism.”

As a sociologist, I study pop culture. My colleagues and I at Toronto Metropolitan University (TMU) and the University of Ottawa recently published a report on how cultural and identity narratives are evolving amid fast-developing digital technologies.

Shortened attention spans

Among younger generations in the United States, the average daily consumption is more than five hours on screens and 237 notifications — about one notification every four minutes.

In a culture of constant connectivity, many young people are navigating a digital world of idealized images, from beauty influencers who subject them to unrealistic comparisons that often lead to feelings of inadequacy and diminished self-worth to an online bro culture that purveys a toxic form of masculinity as a path to success.

For cultural theorist Byung-Chul Han, this is a sign of the decline in storytelling. Modern readers have lost the ability to engage deeply with narratives. The “long, slow, lingering gaze” that allows for daydreaming and true distraction has been replaced by a hyper-focused engagement with constant streams of information. As a result, narration is in crisis.

Recently, a team of researchers at TMU who study workplaces from the perspective of young workers created a two-minute-and-40-second video to engage students on the topic of what young workers want from their work.

Students couldn’t follow the entire video and felt it was too long. As a result, the team had to edit it into a series of much shorter clips — some as brief as 16 seconds — so they could capture the attention of their audience. Should this come as a surprise?

Modern media and technology constantly remind us to preserve our memory and protect our history. However, memory is paradoxical in that it involves forgetting and absence with every act of remembrance.

Online platforms, with their ephemeral content, risk contributing to a cultural memory loss since so much of what’s shared on these platforms is transitory and geared toward superficial engagement rather than meaningful cultural expression.

When brains rot, truth fades

In his memoir, American writer and naturalist Henry David Thoreau lamented society’s declining capacity for deep thought and intellectual effort, favouring instead simple and superficial thinking.

In 1854, he wrote in his book Walden:

“While England endeavors to cure the potato-rot, will not any endeavor to cure the brain-rot, which prevails so much more widely and fatally?”

Thoreau may have seen a future where the U.S. would be led by a president who not only lacks the capacity for deep thought and self-reflection but also disregards historical facts and moral values.

Despite his reputation as a pathological liar, Donald Trump exemplifies what philosopher Harry Frankfurt defined as a bullshitter — a person who does not mislead in the way a liar does, by deliberately making false claims about reality, but rather by speaking without any regard for truth at all.

Bullshitters shift the rules of conversation by making questions of truth and falsehood irrelevant. Lies and the truth simply become tools that can be used to tell their story — regardless of the facts.

The bigger picture

Georg Simmel was one of the first social scientists who expressed concern about the impact of modern life on mental health. In 1903, writing about Berlin, he described blasé attitude as a psychological condition that arises when the brain is subjected to an overwhelming number of stimuli. To cope, it develops a defense mechanism: becoming indifferent to its surroundings.

One century later, when our online feeds are flooded with endless digital content, it is uncanny to revisit Simmel’s observation. We must move beyond traditional diagnostic digital literacy and competency frameworks. The problem lies not only in the technology itself, but in the broader socio-economic system in which it operates — a consumer-capitalist-digital complex that is eroding our brains and cultures.

Humans have always been fascinated by stories. We need them to understand ourselves. However, social media’s profit-driven algorithms homogenize experiences and ultimately undermine cultural diversity. We have become storysellers instead of storytellers.

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In April 2022, Ontario became the first province in Canada to regulate online gambling and sports. This opened the door to an industry that brought in $1.4 billion in revenue over the next year, making Ontario one of North America’s top five online gambling industries.

Quarterly wagers have more than quadrupled since iGaming Ontario (iGO) launched in 2022 and continue to grow, reaching 18.7 billion in the second quarter of 2024, and topping 72 billion in the past year. Despite this massive industry growth and revenue, we lack reliable data on how this shift affects Ontarians. As researchers working in the field of gambling studies, we feel a duty to highlight these risks, but are increasingly concerned about the lack of an independent research body in Ontario to monitor the situation.

The need for data on gambling

What’s profitable for the gaming industry — revenue from gamblers’ losses — is often problematic for players. Ads for gambling tend to depict it as exciting, but the reality for some players, especially those with gambling problems, is far from glamorous — a fact acknowledged by the requirement that ads and gambling sites provide a link to addiction and problem gambling services.

So, how serious is problem gambling in Ontario?

In 2018, Statistics Canada estimated that 1.1 per cent of Ontarians experienced problem gambling. However, a recent study, still awaiting peer review, by some of this article’s authors found that rate closer to nine per cent just before the launch of iGO. In a December 2024 report, Mental Health Research Canada reported it at 11 per cent in Ontario.

These numbers, along with a spike in calls to the Ontario Problem Gambling Helpline about online gambling, indicate a notable rise in problem gambling since iGO’s introduction. This suggests that Ontario’s online gaming expansion may be fuelling a concerning increase in gambling issues.

The problem may be even worse today, but it’s difficult to determine. The Ontario government, which generates significant tax revenue from online gambling, has not announced any funding for independent research to monitor its impact.

More gambling options, and increased accessibility

Most Canadians gamble in some form, whether it be purchasing lottery tickets, betting on sports or playing at the casino. With the rise in gambling options and increased accessibility, it is crucial to understand how these changes are affecting problem gambling across the province.

Problem gambling leads to serious harms beyond financial loss. It can strain familial and other interpersonal relationships and perpetuate cycles of poverty across generations.

One of the most alarming aspects of problem gambling is its association with suicide. Studies in community samples show that 17-39 per cent of those with problem gambling report suicide ideation; in those individuals seeking treatment for gambling, seven to 30 per cent report suicide attempts. Research from 2023 found that as problem gambling severity increases, so too does the risk of suicide attempts, regardless of previous experience with problem gambling.

These findings, coupled with Ontario’s high rates of problem gambling prior to the launch of iGO, underscore the urgent need for independent research on the impact of online gambling.

Gambling and public health

Gambling is undeniably a public health issue. Like alcohol and tobacco, gambling is highly addictive, with research showing that a significant portion of gambling revenue comes from those who are experiencing harms as a result of gambling. With the industry generating massive revenue, it’s essential to ensure the profits aren’t predominantly driven by those struggling most.

Ontarians deserve clear information about the direct and indirect impact of the introduction of online gambling, including any increases in problem gambling. The ease of placing a bet online, alongside mechanics of iGaming that encourages continuous play, aligns with tactics seen in video games that encourage young users to spend money on in-game items like “loot boxes” and “skins” — potentially influencing the next generation of gamblers.

It is the position of the Ontario Gambling Research Society (OGRS), whose purpose is to support independent research on gambling in Ontario and of which the authors of this story are members, that there is a need for independent oversight and arm’s-length work that is in the public interest.

New forms of online sports betting have been aggressively marketed, and smartphones can become easily accessible pocket-sized casinos. This setup risks creating a new generation of problem gamblers, whose suffering will extend to their families and will ultimately require treatment resources.

These resources should match the need created by online gaming, but without objective, independent research, we have no reliable gauge of that need. Ontario urgently requires transparent and meaningful research to understand and respond to the impact of its government-sanctioned online gambling expansion.

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Canada is on the verge of becoming a “super-aged” nation — a term that refers to nations where 21 per cent or more of the population is aged 65 or older. At present, Japan, Italy, Finland and Germany all meet this criteria, and Canada is expected to reach this milestone by early 2030.

This demographic shift has various societal implications, particularly when it comes to caregiving. More than eight million Canadians provide some kind of caregiving support to family members and friends, and 28 per cent care for loved ones with age-related conditions.

Since clothing can be a reflection of one’s personal identity, supporting successful aging should include shopping well-being. Our forthcoming study looked into the experiences of caregiver baby boomers who shop for the elderly, and how these experiences impact their well-being.

We examined how factors like fashion interest, shopping involvement and price sensitivity influence baby boomers’ shopping satisfaction and well-being. By understanding these influences, we aim to better support caregivers by improving the shopping experience for older adults and the ones who care for them.

The baby boomer caregiving experience

Elderly individuals often have difficulty moving around and rely on family members and friends for many daily activities, including shopping. In Canada, 40 per cent of seniors experience physical or mobility impairments, which increases their dependence on caregivers.

For boomers, caregiving is not merely about running errands — it’s also a meaningful activity that impacts the quality of life of their aging family members and friends.

Shopping for clothes, in particular, can be challenging for caregivers because it involves considering personal preferences, physiological needs and the emotional expression of an individual and their identity through fashion.

Adult children may find themselves more emotionally engaged when shopping for their parents than when shopping for themselves. Our study found that shopping for others, especially in a caregiving context, involves greater accountability and effort.

When boomers pick out an article of clothing for the elderly, they consider not only the practical aspects like comfort and ease of care, but also how the item will make them feel.

Shopping as a bonding experience

Our study reveals that boomers’ enjoyment and satisfaction during these shopping trips are driven primarily by their fashion sense and the pleasure derived from selecting stylish, yet suitable, clothes for the elderly people in their lives.

Practical considerations, like price sensitivity, appeared to take a backseat when shopping for a loved one. As such, caregiver baby boomers are willing to spend more money to ensure their elderly family members’ and friends’ happiness and comfort, indicating that the emotional reward outweighs the financial cost.

Our study found that baby boomers who are quick to adopt new fashion trends and influence others’ style choices perceive higher social value when shopping for others. This suggests that, by choosing clothes that look and feel good, boomers feel a sense of accomplishment and social validation.

This social connection is essential for caregivers. Shopping can be a social activity that fosters connections and reduces feelings of loneliness. For boomers, discussing fashion with their parents or friends, getting feedback and seeing their joy in wearing a new outfit provides emotional fulfilment. It transforms a mundane task into a bonding experience that boosts their well-being.

What this means for retailers

Given our research findings, there are several practical implications for retailers. Understanding that emotional and social values are significant to older caregivers, retailers can create more engaging and supportive shopping environments.

For instance, providing personalized shopping assistance, offering products that cater to both comfort and style and creating a welcoming atmosphere can significantly enhance the shopping experience for caregivers.

Retailers can also implement initiatives that focus on the emotional aspects of shopping. This might include fashion shows or marketing campaigns featuring elderly models, special discounts for caregivers or the elderly and community events that bring caregivers and their loved ones together in a social setting.

Recent examples of this include Dove’s “Real Beauty” Campaign, Shoppers Drug Mart senior’s day, Cadillac Fairview’s mall walking program and advocacy groups like the Canadian Association of Retired Persons. These efforts can help build a loyal customer base while also addressing the unique needs of this demographic.

The shopping experiences of baby boomers as caregivers are multifaceted, involving emotional, social and practical dimensions. By acknowledging and addressing these aspects, we can better support caregivers, enhance their well-being and create a more inclusive and empathetic retail environment.

For caregivers, shopping is more than just a task; it’s an act of love and care that significantly impacts their quality of life and the lives of those they care for.

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A game world is a fantasy universe based on a story and a theme.

In learning contexts, such as in schools or professional continuing education, game worlds permit us to teach complex subjects in an engaging way by rehearsing competencies and roles in a fictional narrative.

But games also invite game users into contemplation. In the work of some researchers, contemplative learning is learning that enables deeper engagement by including elements from the learner’s world that enhance the educational context. In a game world, this could mean enabling an understanding of other cultures, reviewing histories of ideas or reflecting on personal reactions to learning while inhabiting new roles and worlds.

With colleagues at the digital media program at Toronto Metropolitan University and the Baycrest Academy for Research and Education, our work is focused on designing game worlds that draw on contemplative learning to provide training for health-care workers who provide or lead care. Our games are also now in use with the World Health Organization, the United Nations and with health-care providers, educators and students in Ontario.

Values central to learning

Contemplative learning can go beyond simple reflection. Contemplative principles to trigger emotional responses in the learner can lead to self-actualization.

Through these emotional responses aided and guided by narrative, learners can experience a deeper understanding of the self and their own lived world.

Contemplative approaches to learning and teaching are not only focused on acquiring knowledge and skills, but also on values and attitudes which are central to learning.

Game world built on myth

Meta-narrative refers to an overall ethical or mythological structure upon which the game world is based. It provides value-added learning that is difficult to effectively deliver through conventional simulation.

Judgments about the value of one’s learning in the real world can be enveloped in meta-narrative.

In other words, mythological stories can elicit specific emotional responses in learners that encourage them to create new templates to organize knowledge and attitudes and enable “spiritual transformation.” With regards to our game world design to train health-care providers, spiritual refers to a quest for meaning, harmony, safety and compassionate responses in clinical care.

Our goal is to introduce and reinforce narrative as an engagement strategy to increase learners’ emotional investment in training.

‘The Carthage Chronicles’

Our first action adventure game, The Carthage Chronicles, is named for an ancient city in what is now Tunisia. Because Carthage was a great trading civilization, players engage in relational care practices with in-game characters from a wide range of geographies, cultures and faiths. The game world setting establishes that co-operation across nations and faiths is a better way to live than through conquest.

A meta-narrative of co-operation across diversity underpinned the entire design. In this way, contemplative pedagogy and game world design is structured to help learners to deal with a multicultural and multi-faith professional world.

To date, more than 2,600 learners have completed The Carthage Chronicles to learn how to manage complex age-related conditions such as dementia. This is supported by Ontario’s Ministry of Long-Term Care as a strategy to train personal support workers and nursing professionals in aging care.

Design, implementation and evaluation are managed by the Ontario Centres for Learning, Research and Innovation in Long-Term Care at Baycrest. This work is directed by Raquel Meyer, one of the authors of this story who holds a doctorate in nursing health services.

‘Hypatia’s Guild’

Following the success of The Carthage Chronicles, we then built a game world called Hypatia’s Guild, which was also funded through the Ministry of Long-Term Care. Both ‘The Carthage Chronicles’ and ‘Hypatia’s Guild’ are tailored to educators working in long-term care homes across Ontario on a platform called Learning Inter-Professionally Heathcare Accelerator (LIPHA).

In the Hypatia’s Guild game world, set in contemporary Ontario, learners role play an immortal being as part of a team of 2,000-year-old superheros.

As one of the first recorded female professors in antiquity, Hypatia was known as a brilliant philosopher, mathematician and astronomer. In our fictional narrative, Hypatia trained a guild of immortals to preserve the knowledge of how to fight evil. Alongside the guild, learners rescue Earth from an alien invasion that leaves people in a state called “acedia.” Acedia is a medieval term that refers to a loss of excitement and engagement in life.

Addressing loss of engagement, burnout

In the Hypatia’s Guild game world, Hypatia and her guild of immortals represent good. They embody the energy that builds life force by nurturing community, creativity and wellness, which in turn foster security, belonging, continuity, purpose, achievement and significance.

Players generate this energy by mastering educator competencies throughout the game. Aliens in the game represent evil; they spread acedia through authority, conformity and negative interference which in turn lead to despair, fear, isolation, meaninglessness and burnout.

The narrative epitomizes a loss of engagement — what could be considered a form of acedia — that is present in health-care work.

Burnout or depersonalization are risks in care-giving situations where work demands far exceed personal and organizational resources. Most recently, these risks were exacerbated by the pandemic, especially in Ontario’s long-term care sector. Systemic, organizational and personal interventions are needed to address these challenges.

Deepening competencies

User evaluations of Hypatia’s Guild attest that through the game, long-term care educators find meaning in their role, deepening their competencies.

And role play enables educators to discover educational resources that enable them to positively shape organizational, team and individual experiences in these care settings.

In this way, learning is deepened beyond acquiring knowledge and skills. Instead, it’s grounded in reflecting upon and practising values and attitudes conducive to ongoing learning and celebrating a diversity of life stories.

The post How game worlds are helping health-care workers practise compassionate clinical responses appeared first on TMU Research & Innovation Blog.

In today’s fast-paced work environments, the quest for inner peace can feel like an elusive dream. In 2021, 62 per cent of health-care workers reported having burnout, while 70 per cent reported depressive symptoms and 29 per cent suffered from post-traumatic symptoms.

Outside of health care, a staggering 80 per cent of American workers say they experience stress at work. Findings indicate stress plays a role in approximately 60 per cent of instances of absenteeism among employees.

The detrimental effects of poor well-being are evident. When employees are unwell, their job performance decreases, they report higher turnover rates and they’re more at risk of burnout.

To combat declining employee mental health, many organizations have turned to mindfulness training to reduce stress. This ancient practice holds promise to reshape the way we live and work.

The benefits of mindfulness

In modern applications of mindfulness, the concept refers to non-judgmental awareness that’s oriented toward staying in the present.

By practising mindfulness, individuals can cultivate a sense of inner calm by reducing negative emotions and enhancing vitality and resilience, making them better equipped to navigate the challenges of the modern workplace.

Mindfulness enhances awareness, allowing individuals to be fully present in the moment, liberated from the burdens of past regrets and future worries. Past studies have found that becoming more present can increase how engaged people feel at work and even increase their job performance.

While mindfulness is enticing, it can be remarkably elusive — especially because in a world addicted to busyness, meditation is not everyone’s cup of tea.

Mindfulness and psychological capital

Our research examined how different types of interventions aimed at improving well-being can enhance psychological capital — a concept encompassing self-efficacy, hope, resilience and optimism.

While most mindfulness intervention studies tend to focus on the efficacy of training on desirable outcomes, we wanted to know how the expectations and beliefs participants held about training might influence its effectiveness in increasing psychological capital.

Expectancy theory argues that motivation is higher when we desire a certain outcome and believe we can obtain a particular result. Could it be, for example, that those who believed more strongly in the power of mindfulness to reduce stress might benefit more from it?

In our study, hospital employees were randomly allocated to one of three groups: mindfulness, Pilates or a control group that was enrolled in neither and placed on a waitlist.

The mindfulness group learned different types of meditation techniques such as breath awareness and loving-kindness meditation. The Pilates group learned exercises that strengthened their core. Those in the control group received no training, but were able to enrol in the mindfulness or Pilates group afterward.

By comparing the experiences of participants in each group, we analyzed how the training each participant received, and the expectations they held, interacted to affect their psychological capital.

Expectations matter

Our research found that increases in psychological capital had as much to do with an individual’s underlying expectations as the training group they were assigned to.

Regardless of the type of training that individuals received, the factors that predicted an increase in psychological capital were individuals who believed: a) their well-being was suffering and b) the training would enhance their well-being.

Our findings show that people can become more mindful and increase their psychological capital regardless of the training condition, especially those who start with very low levels of self-efficacy, hope, resilience and optimism.

In other words, believing that you need the wellness activities you engage in and that they will be beneficial matters just as much as the actual activities themselves.

Alternatives for mindfulness skeptics

It is essential to recognize that meditation, like exercise, does not resonate with everyone, despite its benefits. One study, for example, found that mindfulness-based practices don’t work for psychologically vulnerable populations.

This research highlights a critical point: the effectiveness of wellness interventions can vary significantly from person to person.

For those who don’t find mindfulness practices appealing, they should be delighted by our findings because they show that diverse wellness interventions — and in this case, both Pilates and traditional mindfulness training — can boost mindfulness to support health and well-being.

Organizational takeaways

From an organizational standpoint, our study underscores how important recognizing and addressing individual differences in motivation and expectation are when crafting wellness interventions for employees.

We offer three practical implications for organizations interested in supporting well-being to consider:

1. Do not underestimate the value of understanding what employees need. Taking the time to understand what employees need, desire and are motivated by can predict the effectiveness of wellness offerings.
2. Educate and promote. Educating employees on the benefits of well-being intervention trainings can enhance their expectations and, accordingly, increase the likelihood they will benefit from it.
3. There is no “one-size-fits-all” solution. By offering a wide array of wellness programs that genuinely resonate with the interests of employees, organizations can increase the likelihood of engagement and positive outcomes. The possibilities are boundless.

For individuals interested in investing in their own well-being, our results suggest that choosing wellness activities that you are genuinely motivated to engage in towards goals that are truly meaningful to you are likely to yield better returns.

Past research has found that doing healthy activities just because you think you should can actually be detrimental. In that spirit, to take care of your well-being, look to what you love and invest your time and energy in that.

The post The power of belief: How expectations influence workplace well-being interventions appeared first on TMU Research & Innovation Blog.

Excess workload has been identified as a root cause of the current health-care crisis in report, after report, after report. Excess workload for front-line staff like nurses contributes to fatigue, burnout, medical error and staff quitting.

After heroically working under decades of austerity policies, nurses are burned out and the health-care system is in collapse. If automakers took the same approach to workload management, not a single car would roll off the line with all five wheels properly connected (did you forget the steering wheel?). Excess workload lies at the root of the health-care crisis in Canada today and the wheels are flying off the cart.

So why then does our health-care system have no systematic approach to measuring workload? There is no objective measure of workload in use that can ensure staff have no more than eight hours of care work to complete in an eight-hour shift. There is a saying: “If you can’t measure it you can’t manage it” and by this standard, the Canadian health-care system is flying blind with regards to staff workloads.

It is no wonder our health-care system is in trouble: How can we set “safe staffing levels” with no measure of workload? Without evidence-based workload management, efforts to stave off the shortfall of nurses with increased hiring and “resiliency” training and other staff retention efforts are doomed to fail.

14 hours of work in a 12-hour shift

While the variability in care work can make measuring workload a challenge, new tools using computer simulation technologies are opening the door to objective workload measurement. Our computer modelling approaches have shown that nurses can have over 14 hours of work to complete in a 12-hour shift.

How are staff supposed to keep up with these demands? By rushing? By skipping non-essential tasks? All too often nurses are working overtime or skipping breaks in an effort to deliver the quality of care they were trained for. No wonder nurses are quitting in droves.

These modelling tools allow us to create virtual care units based on actual unit conditions. These models have shown the impact on nurse workload goes well beyond nurse-patient ratios as is currently being discussed.

Making sure workload is balanced to the length of a nurse’s shift requires considering a number of factors, including:

• the needs of the patient, including acuity and dependency levels,
• the layout of the unit and positioning of medicines and materials,
• the location of the beds assigned, and
• the policies and practices that determine the time needed for between-shift hand-offs, safety huddles and data entry.

All of these factors can increase workload and contribute to missed care as tasks are left undone by the end of a nurse’s working shift.

If you consider the donning and doffing of personal protective equipment required for caring for those with COVID-19, for example, a nurse might spend half of their shift simply dealing with the PPE. Where is the time to deal with the extra needs of these patients?

Excess workloads compromise care quality, and workload for nurses can vary from day to day. It can also vary considerably between units and hospitals. There is no one-size-fits-all ideal nurse-patient ratio, but workload measures can help ensure the right number of staff are allocated for the needs of the patients each day.

Evidence-based workload management

The health-care system needs evidence-based workload management to stop desperately overworked health-care staff from quitting.

Similarly, privatizing health care will not help. The entire purpose of for-profit health care is to extract money from the system for investors. That’s its raison d’être. The way most private health-care systems achieve profit growth is by cutting corners and pressing staff to work faster. Do you really want your loved one’s nurse or caregiver rushing through their required care?

The “temp” agency nursing debacle illustrates the privatization problem. Nurses are hired away from hospitals, given better working conditions and then rented back to the same hospitals at exorbitant rates for shareholders’ profit. This scam cost Newfoundland and Labrador alone over $35 million in under six months in 2023.

The United States, the poster child of for-profit health care, has by far the highest health-care costs globally with per capita costs over double those in Canada. At the same time, the U.S. has some of the worst health-care outcomes in the world with the lowest life expectancy and highest mortality rate from treatable diseases among comparable countries. The U.S. system is a warning beacon of the disaster that is private health care. In for-profit health care, everyone suffers — except the investors.

None of these privatization efforts will solve the need to manage workloads for nurses and ensure staffing capacity meets patient needs. Until health-care decision-makers employ objective tools, the drive for cost reduction will continue to drive nurses into overload at work, and both staff and patients will suffer.

Better work means better care

New measurement tools enable precisely quantifying and understanding the real drivers of nurse workload. It’s time to move beyond “magical thinking” in health care to use modern workload management tools in health-care system design and management.

Better work for nurses and other health-care professionals means better and safer care for patients. This is the inspiration behind the Better Work Better Care coalition, an open network of researchers and practitioners for the exchange of knowledge on how to improve the health-care system in healthy ways.

One of the key strategic lessons of the Better Work Better Care approach is the importance of including “improved working conditions” as a measurable indicator in all process improvement efforts. This is critical, as attempts to improve the system that ignore workload are doomed to failure as staff fatigue and work overload will compromise care quality and, eventually, also increase costs related to both patient treatment and staff retention losses.

If Canadian health-care leaders and policymakers want to stop the bleeding of staff losses and shortages, then they need to address the elephant in the room: health-care staff workloads. There are tools to measure and manage workload in health care; they need to be put to use.

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