Associate Professor
BA, McGill, PhD, UBC
Rm 440, 2206 East Mall
Vancouver, BC V6T 1Z3
phone: 6048275393
fax: 6048220640

Dr. Paul Kershaw is a farmer morning and night. By day, he is an academic, public speaker, media contributor and volunteer.  At the University of BC, he is a leading scholar of public policy, and a faculty member in the Human Early Learning Partnership.  In the Faculty of Medicine, he focuses on the major policy levers that influence the social determinants of health, with a particular interest in policy that shapes these determinants for younger generations.  The Confederation of University Faculty Associations of BC awarded Dr. Kershaw in 2016 its prize for “Academic of the Year.”

Before joining the Faculty of Medicine, Paul earned tenure at UBC in 2010 in the College for Interdisciplinary Studies, publishing routinely in political science, sociology and health related journals, and earning two national prizes from the Canadian Political Science Association for his scholarship regarding gender and public policy.  Thereafter, he judged that the peer reviewed literature was having little influence on how Canadian governments budget for the social determinants, particularly as it relates to younger generations.  In response, Kershaw now devotes considerable time to the community engagement commitment in UBC’s Strategic Plan, Place and Promise, to “Be a leader in fostering public understanding of societal issues and in stimulating action for positive change.”  His work aims for the existing literature to have greater potential to influence Canadian government budgets and political platforms across the ideological spectrum.

To support this aim, Kershaw has founded the Generation Squeeze knowledge mobilization campaign, co-hosted at the University of BC and the non-profit Association for Generational Equity (AGE).  The campaign is building a powerful organization to speak up for younger Canada in the market place and the world of politics, and is intended to become the largest community engagement initiative ever launched from a Canadian university.  With numerous partners, Kershaw has designed the campaign to be a rigorously evaluated pan-Canadian population health initiative that responds to the recommendation of the WHO Commission on the Social Determinants of Health to tackle the inequitable distribution of power. 

There is presently an unintended power imbalance between older and younger generations in Canada as it relates to government budgeting.  For example, whereas the Canadian Association of Retired Persons (CARP) exists to advocate for the aging population, there had been no pan-Canadian organization to speak up for younger generations until Generation Squeeze started.  Younger generations are also a third less likely to cast a ballot during elections compared to older generations, even though political parties shape their platforms around who shows up.  As a result, there is a generational spending gap in Canadian budgets which largely accounts for why international comparisons position Canada near the bottom of OECD countries when it comes to investing in the social determinants of health for the generation raising young children.  Kershaw is researching and evaluating the degree to which supporting younger Canadians to mobilize equal generational power alongside their parents and grandparents can mitigate the political-cultural factors which currently result in Canada’s poor international ranking, and slow pace of implementing the existing research about the social determinants of health for younger generations.

Dr. Kershaw is recruiting graduate students who are keen to work and study as part of the Gen Squeeze Research and Knowledge Translation Lab.  Students interested in working with Dr. Kershaw should first review the Gen Squeeze website, and explore whether their interests overlap with policy areas identified at

SPPH 580N Knowledge Translation in Population & Public Health

Dr. Kershaw is recruiting graduate students who are interested in collaborating as members of the Gen Squeeze Research Lab.  Prospective students are encouraged to review the Gen Squeeze website, and explore whether their research interests overlap with policy areas identified at

Paul is currently recruiting graduate students who are keen to change their communities, provinces and country by studying (a) policies that influences the social determinants of health for younger generations, including benefit/cost analyses; (b) the distribution of Canadian government spending and revenue collection by age; (c) evaluation of population health interventions that aim to tackle the inequitable distribution of power between generations; (d) pan-Canadian and international monitoring of family policy investments; and (e) knowledge translation and mobilization.

According to Place & Promise, UBC “exists for the community it serves:  local, provincial, national and global.”  To this end, UBC aspires to “be a leader in fostering public understanding of societal issues and in stimulating action for positive change.”  Accordingly, I have devoted my research and publishing since earning tenure to serve this UBC goal.  I made the decision to emphasize this part of the Place & Promise strategic plan because there is now ample evidence that decades of excellent peer-reviewed research about gender equality and child development are insufficient to motivate Canadian governments to invest in family policy on par with other countries. In response, I began prioritizing publishing research for public consumption and the media as part of a broader knowledge mobilization plan to foster public understanding of the rationale for new investments in younger generations, as part of a strategy to build political will to invest. 

Recent Studies include:

Kershaw, Paul.  2015.  “By the Numbers: a generational guide to voting in the 2015 federal election.”  Vancouver, BC:  Generation  Squeeze


Kershaw, Paul and Lynell Anderson.  2015.  “Federal Favouritism:  Why does the federal government spend five times more per retiree than per person under 45?”  Vancouver, BC:  Generation Squeeze.


Kershaw, Paul.  2015.  “Population Aging, Generational Equity and the Middle-Class.”  Vancouver, BC:  Generation Squeeze.


Kershaw, Paul.  2015.  “Measuring the Age Gap in Canadian Social Spending.”  Vancouver, BC:  Generation Squeeze.


Kershaw, Paul.  2015.  “Building Political Will for a Low Carbon, High Prosperity Canada.”  In Acting on Climate Change:  Extending the Dialogue Among Canadians.  Montreal, Quebec: Sustainable Canada Dialogues.

Newspaper and magazine articles

Kershaw’s research about public policy and intergenerational fairness have been published hundreds of times in newspapers and magazines since 2011, including in the Globe and Mail, Vancouver Sun, Calgary Herald, Edmonton Journal, Toronto Star, Macleans, among many others.

He is also a regular expert commentator for print, radio and TV journalists.  Samples of this work are available upon request.



 Kershaw, Paul. Carefair: rethinking the responsibilities and rights of citizenship. Vancouver: University of British Columbia Press, 2005. 228 pages.

             [1] Carefair is listed among the “Key Writers and Further Reading” in Ruth Lister’s 2007 review of the impact of feminism on citizenship scholarship (Lister, Ruth. 2007a. Citizenship. In The Impact of Feminism on Political Concepts and Debates, edited by G. Blakeley and V. Bryson. Manchester: Manchester University Press).  See CV Appendix 1.

 Kershaw, Paul, Lori Irwin, Kate Trafford and Clyde Hertzman. 2005.  The British Columbia Atlas of Child Development. 1st. Victoria, BC: Western Geographic Press, 212 pages.

 Journal Articles

 Kershaw, Paul, and Tammy Harkey. 2011. “The politics and power in caregiving for identity:  insights for Indian Residential School Truth and Reconciliation.” Social Politics no. doi:10.1093/sp/jxr015:1-26.

 Kershaw, Paul.  2010. “Caregiving for Identity is Political: Implications for Citizenship Theory.” Citizenship Studies 14(4): 395-410.

 Kershaw, Paul, Bill Warburton, Lynell Anderson, Clyde Hertzman, Lori Irwin and Barry Forer. 2010. “The Economic Costs of Early Vulnerability in Canada.”  Canadian Journal of Public Health-Revue Canadienne De Sante Publique 101 (Supplement 3):S8-S12.

 Kershaw, Paul, and Barry Forer. 2010. Selection of area-level variables from administrative data.  An intersectional approach to the study of place and child development. Health and Place 16:500-511.

 Kershaw, Paul. 2010. The ‘Private’ Politics in Caregiving:  Reflections on Ruth Lister’s Citizenship:  Feminist Perspectives. Women’s Studies Quarterly 38 (1&2):302-311.

 Pulkingham, Jane, Sylvia Fuller and Paul Kershaw.  2010.  “Lone-motherhood, welfare reform and active citizen subjectivity.”  Critical Social Policy, 30(2): 1-25.

 Kershaw, Paul, and Lynell Anderson. 2009. Is a pan-Canadian system of early child development possible?  Yes, when we redress what ails Canadian culture. Paediatrics and Child Health 14 (10):685-688.

 Kershaw, Paul, Barry Forer, Jennifer E.V.  Lloyd, Clyde  Hertzman, William T.  Boyce, Bruno D. Zumbo, Martin  Guhn, Constance  Milbrath, Lori G.  Irwin, Jennifer Harvey, Ruth  Hershler, and Anthony  Smith. 2009. The Use of Population-Level Data to Advance Interdisciplinary Methodology:  A Cell-through-Society Sampling Framework for Child Development Research. International Journal of Social Research Methodology 12 (5): 387-403.

 Kershaw, Paul, Jane Pulkingham, and Sylvia Fuller. 2008.   Expanding the Subject:  Violence, Care and (In)Active Male Citizenship. Social Politics: International Studies in Gender, State and Society 15(2):  182-206.

 [1] As first author, Kershaw wrote the initial draft of the article, presented it at the Canadian Political Science Association (CPSA) Meetings, and earned the 2007 Jill Vickers Prize from the CPSA.  Co-authors subsequently helped revise the article in the light of our data collection collaboration and analytic dialogues. 

 Fuller, Sylvia, Paul Kershaw, and Jane Pulkingham. 2008. Constructing “Active Citizenship”: Single Mothers, Welfare, and the Logics of Voluntarism. Citizenship Studies 12 (2):157-176.

 Kershaw, Paul, Barry Forer, Lori G. Irwin, Clyde Hertzman, and Vanessa Lapointe. 2007. Toward a Social Care Program of Research: a study of neighborhood effects on child development Early Education and Development 18 (3):  535-560.

 Kershaw, Paul. 2007.  Measuring Up: BC and Alberta Family Benefits in International Perspective. Choices. 13 (2): 1 – 42.

 Kershaw, Paul. 2006.  Carefair: Choice, Duty and the Distribution of Care. Social Politics: International Studies in Gender, State and Society 13 (3): 341 – 371.

 [1] The Canadian Political Science Association awarded Kershaw the 2005 Jill Vickers Prize for this article when presented at its 2004 Annual Meetings.

 Kershaw, Paul. 2011.  “‘Carefair: el cuidado equitativo. Entre la capacidad de elegir, el deber y la distribución de las responsabilidades. Debates Feminista 44 (22).        

 [1] This article is a Spanish translation of Kershaw’s 2006 article, “Carefair: Choice, Duty and the Distribution of Care”.  Cecilia Olivares, deputy editor of Debates Feminista, solicited permission to translate and reprint the article because “it is fundamental to the issues being discussed today by feminism.” See CV Appendix 2.

 Goelman, Hillel, Barry Forer, Paul Kershaw, Gillian Doherty, Donna Lero and Annette LaGrange. 2006.  Towards a predictive model of quality in Canadian child care centers. Early Childhood Research Quarterly. 21 (3): 280 – 295.

 Kershaw, Paul.  2006. Weather Vane Federalism: Reconsidering Federal Social Policy Leadership. CANADIAN PUBLIC ADMINISTRATION-ADMINISTRATION PUBLIQUE DU CANADA. 49 (2): 196 – 219.

 Kershaw, Paul, Barry Forer and Hillel Goelman. 2005.  Hidden Fragility: Closure among Child Care Services in BC. Early Childhood Research Quarterly. 20 (4): 417 – 432.

 Kershaw, Paul. 2004.  ‘Choice’ Discourse in BC Child Care: Distancing Policy from Research.  CANADIAN JOURNAL OF POLITICAL SCIENCE-REVUE CANADIENNE DE SCIENCE. 37 (4): 927 – 950.

 Kershaw, Paul. 2002.  Beyond the Spousal Tax Credit: Rethinking the Tax Treatment of Caregiving and Dependency (Again!) in the Light of the Law Commission Report”. Canadian Tax Journal. 50 (6): 149 – 178.

 Kershaw, Paul. 2002.  The Politics of Time: Integrating a Richer Appreciation for Work-Family Balance into the Canadian Welfare Regime. Canadian Review of Social Policy. 49/50 (Spring/Fall): 113 – 138.

 Refereed Book Chapters

Kershaw, Paul.  White Cowboy, Black Feminism, Indian Stories.  2011.  In Feminist Community Research:   Case Studies and Methodologies, edited by W. Frisby and G. Creese.  Vancouver:  University of British Columbia Press, 147-168.

Hertzman, Clyde, Paul Kershaw, Lori G. Irwin, and Kate Trafford. 2009.  Guide to the British Columbia Atlas of Child Development.  In The Challenges of Student Diversity in Canadian Schools:  Essays on Building a Better Future for Exceptional Children, edited by J. Lupart. Toronto, Ontario: Fitzhenry & Whiteside, 157-188.

Kershaw, Paul. 2008. Social Care. In Recasting the Social in Citizenship, edited by E. Isin. Toronto: University of Toronto Press, 44-68.

 Kershaw, Paul. 2008. Carefair:  Gendering Citizenship ‘Neoliberal’ Style. In Gendering the Nation State, edited by Y. Abu-Laban. Vancouver: UBC Press, 203-219.


 *  Kershaw, Paul, and Lynell Anderson. 2011a. Does Canada Work for All Generations:  Alberta Family Policy Report.

 *  ———. 2011b. Does Canada Work for All Generations:  British Columbia Family Policy Report.

 *  ———. 2011c. Does Canada Work for All Generations:  Manitoba Family Policy Report.

 *  ———. 2011d. Does Canada Work for All Generations:  New Brunswick Family Policy Report.

 *  ———. 2011e. Does Canada Work for All Generations:  Newfoundland and Labrador Family Policy Report.

 *  ———. 2011f. Does Canada Work for All Generations:  Nova Scotia Family Policy Report.

 *  ———. 2011g. Does Canada Work for All Generations:  Ontario Family Policy Report.

 *  ———. 2011h. Does Canada Work for All Generations:  Prince Edward Island Family Policy Report.

 *  ———. 2011i. Does Canada Work for All Generations:  Quebec Family Policy Report.


*  ———. 2011j. Does Canada Work for All Generations:  Saskatchewan Family Policy Report.

[1]Before the publication of these 10 reports, Canadians have not been in a position to compare a comprehensive range of family policy investments across provinces in the way that we can compare investments in medical care, pensions, kindergarten to grade 12 education, etc.  Intergovernmental reporting mechanisms simply do not produce adequate metrics for family policy.  The absence of comparative data contributes to the cultural perception that there is no public policy problem to solve.  The release of the 10 family policy reports – one for each province — aims to fill this gap in evidence. 

 The 10 reports were written to be accessible for lay audiences.  As a measure of success, their release received substantial print, radio and TV coverage across all of Canada, including in 66 print news stories in the first three days, and another 18 broadcast interviews.  The latter included TV coverage on Global News and CTV News.

 In addition to media attention, the release of the reports resulted in a YMCAs across the country convening a national speaking tour to engage Canadians in public dialogue around the question “Does Canada Work for All Generations?”  The result has been a series of policy conversations in communities that span from Victoria to Halifax, whereby YMCAs facilitated the distribution of Kershaw’s UBC research with local constituents. 

 *  Kershaw, Paul, Lynell Anderson, Bill Warburton and Clyde Hertzman.  2009.  15 by 15:  A Comprehensive Framework for Early Human Capital Investment in British Columbia.  Vancouver, BC:  Human Early Learning Partnership.

 [1]This report generated enormous interest in BC, and across the country, because it was the first study in Canada to use population-level, linkable data to estimate the cost of early child vulnerability to a provincial economy; to propose concrete policy solutions; and to provide a comprehensive benefit/cost analysis of the policy recommendations. In the first six months following its publication, I was invited to give 28 presentations about the report findings, brief the Ministry of Children & Family Development, the Minister of Education, the Minister of Act Now BC & the Olympics, the Official Leader of the BC Opposition, the BC New Democratic Party Caucus, as well as 9 Broadcast media interviews and interview coverage in 22 Newspaper/Magazine articles.  The report continues to generate speaking requests to this day.

 Newspaper and Magazine Articles (Sample)

 Kershaw, Paul.  “What’s really needed to raise families.”  The Globe and Mail.  August 27, 2013.

 Kershaw, Paul.  “How BC’s New Democrats ran aground on Generation Squeeze.” The Globe and Mail. May 16, 2013. 

 Kershaw, Paul.  “An inexpensive way to reduce child poverty.”  Waterloo Region Record.  May 15, 2013.

 Kershaw, Paul & Lynell Anderson.  “Platforms push wider gap between generations.” Vancouver Sun. May 3, 2013.

 Kershaw, Paul.  “How to help those under 45?  Talk. Party. Act.”  Coquitlam Now. March 20, 2013.

 Kershaw, Paul.  “Governments should talk to my grandma before preparing budgets.”  Guelph Mercury. March 13, 2013.

 Kershaw, Paul.  “Solutions exist to safeguard younger generations.”  Maple Ridge & Pitt Meadows Times.  March 7, 2013.

 Kershaw, Paul.  “Younger generations need to start voting.”  Burnaby Now.  March 3, 2013.

 Kershaw, Paul.  “Costs too high for younger generation.”  The Record (New Westminster).  February 22, 2013.

 Kershaw, Paul.  “Budget priorities ignore younger generations.”  The Province.  February 21, 2013.

 Kershaw, Paul.  “Generation Squeeze is fighting back with WTF? Parties.” The Province.  November 14, 2012.

 Kershaw, Paul.  “Why do we spend so little on Canadians under 45?”  The Globe and Mail. October 29, 2012.

 Kershaw, Paul.  “We are the 99% ignores generational divide.” (Printed as “Forget Occupy, the real divide is generational.” The Globe and Mail. September 21, 2012.

 Kershaw, Paul.  “Students outside Quebec have more to protest.”  The Province.  August 31, 2012.  . 

 Kershaw, Paul.  “Canada defaulting on generational debt.”  Vancouver Sun.  June 4, 2012.

 Kershaw, Paul.  Canadian politics in a word.” Vancouver Sun.  May 26, 2012.

 Kershaw, Paul.  Quebec student strikes invite intergenerational conversation.”   Vancouver Sun.  May 22, 2012. 

 Kershaw, Paul.  Truth about Taxes.” (Printed as “Canadian taxes not as high as you may think).  Vancouver Sun.  April 26, 2012.

 Kershaw Paul.  Surrey Board of Trade Befriends Gen Squeeze.” Vancouver Sun. April 12, 2012.

 Kershaw, Paul.  Federal budget:  generational analysis distorted by government and opposition.”  (Printed as “Canada is not doing right by its under 45 citizens).  Vancouver Sun.  April 4, 2012.

 Kershaw, Paul.  Families First?  What it has been.  What it should be.  Vancouver Sun.  March 27, 2012.

 Kershaw, Paul.  Education dispute ignores Gen Squeeze.”  Vancouver Sun.  March 20, 2012.

 Kershaw, Paul. “WTF Parties:  A Tonic for Democracy.”  Vancouver Sun.  March 13, 2012.

 Kershaw, Paul.  Canadians unconvinced about medical care spending increases.” Printed as “How to Finance a New Deal for Families.”  Vancouver Sun.  March 5, 2012. 

 Kershaw, Paul.  The case for shorter work years and longer work lives.” Vancouver Sun. February 7, 2012.

 Kershaw, Paul. “A Canadian sidekick for Colbert:  Captain BEAVER.” Vancouver Sun.  January 31, 2012.

 Kershaw, Paul. “Women shortchanged in retirement because bad deal for families.”  Vancouver Sun.  January 24, 2012.

 Kershaw, Paul.  Neglecting climate change an intergenerational crime?” (Printed as “Climate change needs an intergenerational solution).” Vancouver Sun.  January 17, 2012.

 Kershaw, Paul.  Poll suggests Boomers are the real ‘ME Generation’.” Vancouver Sun.  January 10, 2012.

 Kershaw, Paul.  Is it really un-Canadian to cap spending on medical care?Vancouver Sun.  December 7, 2011.

 Kershaw, Paul. “New Deal for Families Tough on Crime.”  Vancouver Sun.  November 30, 2011.

 Kershaw, Paul. “Income splitting is not the solution.” Vancouver Sun.  November 21, 2011, A13.

 Kershaw, Paul. “New Deal for Families Promotes Truth and Reconciliation  Vancouver Sun.  November 17, 2011, A15.

 Kershaw, Paul. “Seismic shift for Gen Squeeze costs Business because of turnover.”  Printed as “Generation Squeeze’s Seismic Shift.”  Vancouver Sun.  October 31, 2011, A9.

 Kershaw, Paul.  “A Canada that Works for All Generations.” Printed as “Boomers, seniors aren’t to blame.”  Vancouver Sun.  November 7, 2011, A11.

 Kershaw, Paul. “Business pays steep price for squeezed employees’ absenteeism.”  Printed as “Bad Deal for ‘Generation Squeeze’.”  Vancouver Sun.  October 24, 2011, A11.

 Kershaw, Paul.  “How today’s parents got squeezed out.”  November 2, 2011.

 Kershaw, Paul. “Occupy Wall Street:  Focus less on fat cats, more on generations.” Printed as “Movement Should Change Focus.”  Vancouver Sun.  October 18, 2011, A11.

 Kershaw, Paul. “A New Deal for families.” Vancouver Sun.  October 12, 2011, A15.

 Kershaw, Paul. “Gen X-It.”  Vancouver Sun.  October 3, 2011, A11.

 Kershaw, Paul. “Intergenerational breach of Trust?”  Printed as “Struggles of the next generation.”  Vancouver Sun.  September 26, 2011,  A7.

Dr. Kershaw is recruiting graduate students who are interested in collaborating as members of the Gen Squeeze Research Lab.  Prospective students are encouraged to review the Gen Squeeze website, and explore whether their research interests overlap with policy areas identified at

Generational Equity & Health

Dr. Kershaw is building an innovative population health economics research and knowledge translation hub focused on federal and provincial policy interventions that shape the distribution of public resources between the needs of an aging population and the social determinants of health for younger generations.  This focus responds to the “Health in All Policies” emphasis of the Rio Declaration on Social Determinants,[i] which encourages analysis of government policy levers in medical care, along with income security, education, family policy, housing, etc. because these levers directly influence the social and economic determinants of health – they are the “determinants of determinants.”[ii]  By building the hub, Kershaw responds to CIHR’s call to close the “consistently identified gap in the… literatures” left by the dearth of “economic analyses to inform and evaluate population health interventions,” as well as address CIHR’s emphasis on “health equity over the life course,” including the “focus on children, youth and families” and “healthy aging.”

 This research and KT hub will serve as:

·       A vital, high quality population health economics policy resource for all levels of Canadian government as they grapple with budgetary pressures created by the old age security and medical care needed by a growing cohort of retirees, and pressures facing Generations X and Y who must adapt to higher student debt, lower wages, and more expensive housing than a generation ago when raising their children. 

·       A novel training ground for promising population health researchers, practitioners and policy makers to integrate analytical frameworks attuned to intergenerational equity with scholarship and knowledge mobilization focusing on policy responses to the social determinants of health and health equity over the life course. 

·       An epicenter for excellence in the application of innovative theories and population-level approaches in knowledge translation.  Kershaw is leveraging existing interdisciplinary and inter-sectoral partnerships with the Health Officers Council of BC, Canadian Doctors for Medicare, Gen Why Media, Echo, United Way, Vancouver Foundation, YWCA, YMCA, Boards of Trade and others into a pioneering, made-for-Canada population level health equity intervention.  The intervention, which will be rigorously evaluated, will minimize the inequitable influence on government budgeting exercised by different generations due to the age gap in voter turnout.

Program of Research: Generational analyses are now critical for population health equity research. Medical care and retirement income pressures are top of mind for government officials and health practitioners as the Baby Boom generation retires.  The efficacy and efficiency of core social supports – like access to medical care on the basis of need rather than ability to pay – must be maximized in order for Canada to support its aging population.  At the same time, the sustainability of these programs is key for younger generations who also hope to have an opportunity to benefit.  This includes acting to prevent illness by investing in the social determinants of well-being to contain future health care costs.   

Simultaneously, socioeconomic trajectories in Canada are unfolding unevenly along generational lines. The dramatic increase in housing prices means more wealth for the generation who bought homes decades ago.  But for generations under age 45, high housing prices mean heavy debt – debt they are struggling to cover in jobs that pay lower wages and fewer pension benefits compared to a generation ago, and household incomes that are not keeping pace with rising costs despite the shift to dual earner families.  With less money and less time at home, more young adults are then are squeezed by the lack of child care services which are hard to find, and often cost more than university tuition.[iii]

In the wake of this time, money and service squeeze on generations raising young kids, research reveals that 20-30% of children across Canada are vulnerable when starting kindergarten.  Most of these children are not poor.[iv]  The resulting societal costs include poorer health, more school failure, more incarceration, less job readiness and slower economic growth.[v] Like the aging population, this trend poses new pressures for governments because public health and epigenetic literatures[vi] are rich with evidence that social determinants yield particularly lasting influences in the earliest years of life, and thus hold tremendous potential to contain medical care and other social spending over the medium term.

Given these demographic and socioeconomic trajectories, it is imperative for health economics scholars to research how Canadian governments are adapting health policy, as well as social and economic policy, to better address social determinants of health.  Evidence suggests that later life course stages are receiving primary attention in public budgeting.  Canadian Institute for Health Information data show that Canadian governments spend around $50 billion more per year on medical care compared to 1976 (measured as % GDP);[vii] and 42% of medical care spending goes to the 15% of Canadians over age 65.[viii]  Statistics Canada data[ix] illustrate that government spending on the Canada Public Pension Plan and Old Age Security is up nearly $30 billion annually since 1976.  Despite this combined spending increase of $80 billion, cumulative government revenue is up around $22 billion.  This imbalance may help to explain why total government spending[x] on parental time at home with newborns, early education and care, and cash benefits for families with children under age six has changed little over the period as a share of GDP (except in Quebec).

Because Canadian governments are slow to adapt to the socioeconomic changes affecting Generations X, Y and their children, UNICEF ranks Canada among the least generous OECD countries with respect to investments in generations raising young children.[xi]  By contrast, international studies place Canada in the top five countries for public medical care spending per capita (although our outcomes are often evaluated as middling).[xii] Canadian government policies regarding retirement income combine with our relatively strong economy to produce a low-income rate for seniors that is among the lowest in the world.[xiii]  This pattern of investment persists into current budget and election cycles, and across party lines.  For instance, in the May 2013 election in BC, the incumbent centre-right Liberal party and the Official Opposition centre-left NDP committed to increasing annual public spending on medical care by $1.5 billion, while dismissing an investment of $1.5 billion on early childhood education and care as unaffordable. 

It is impossible to evaluate the merits of such trade-offs for public health in the absence of a generational analysis.  Currently, no organization provides this analysis in a routine and comprehensive way, and little academic literature probes the generational distribution of government expenditure in the Canadian context.  Dr. Kershaw’s program of research about Generational Equity & Health responds to this void and is creating a valuable practical resource for governments as they set priorities for Ministries of Health, as well as Ministries responsible for the social determinants of health.




[i]Rio Political Declaration on Social Determinants of Health.  Rio de Janeiro, Brazil, 21 October 2011, Section 7.

[ii] National Collaborating Centre for Healthy Public Policy. 2013.  Health Impact Assessment, See “Action on the determinants of health.”

[iii]Kershaw, P. and L. Anderson. 2011. Does Canada Work for All Generations: Ontario Family Policy Report.

[iv]Kershaw, P. et al. 2005. The BC Atlas of Child Development. Victoria, BC: Western Geographical Press.

[v]Kershaw, P. et al. 2010. “The Economic Costs of Early Vulnerability in Canada.” Canadian Journal of Public Health

no. 101 (Supplement 3):S8-S12.

[vi]Keating, D. P. and C. Hertzman. 1999. Developmental Health & the Wealth of Nations. New York: Guilford Press.

[vii] Author calculation of public health care spending divided by GDP at market prices.  Canadian Institute for Health Information (CIHI).  2012.  National Health Expenditures Trends, 1975 – 2012. Table A.2.1., Column E. CANSIM Tables 380-0016 – Gross Domestic Product, income based (annual); and 380-0063 – Gross Domestic Product, income based (quarterly).   See also Askari, M. et al. 2013. Fiscal Sustainability Report 2013. Ottawa. Figure 5.4.

[viii] CIHI.  2012, op cit.  Table E.1.1.

[ix]Statistics Canada. Table 380-0007 – Sector accounts, all levels of government, quarterly (dollars).

[x] Author calculation based on Statistics Canada. Table 380-0007; and provincial budget documentation, eg: Government of BC.  Public Accounts of British Columbia for the Fiscal Year ended March 31 1976.

[xi]UNICEF. 2008. “The child care transition.” In Innocenti Report Card 8. Florence: Innocenti Research Centre.

[xii]OECD. 2011. Health at a Glance 2011:  OECD Indicators. OECD Publishing.

[xiii]Commission on the Social Determinants of Health. 2008. Closing the gap in a generation:  health equity through action on the social determinants of health. Geneva:  World Health Organization, p. 85.