Social Determinants of Health
Social determinants of health (SDOH) are defined as factors that influence health outcomes and are closely linked to health equity (Edwards & Cohen, 2012).
There are 12 key SDOH listed on the Government of Canada’s website (2011). These SDOH include: income and social status, social support networks, education and literacy, employment/working conditions, social environments, physical environments, personal health practices and coping skills, healthy child development, biology and genetic endowment, health services, gender and culture.
Key points from curated resources related to SDOH from a Canadian perspective include:
1. CANADA: Although Canada is considered a leader in health promotion and population health, implementation of policy to improve social determinants of health have been inadequate. (Raphael, Curry-Stevens, & Bryant, 2008).
2. BARRIERS:
Barriers that limit making SDOH a policy priority:
Long time investment-competing political agendas, biomedical model focus, challenges of collaboration between governments and organizations and perceived lack of evidence on population health initiatives (Smith, Mitten, & Kershaw, 2016).
3. FUTURE PRIORITIES:
Future priorities address serious health equity gaps in Canada. These gaps can be overcome if all sectors address SDOH and respond to vulnerable populations as our most serious health equity gaps [e.g. the gap between Aboriginal peoples and other Canadians (Edwards & Cohen, 2012)].
4. POPULATION HEALTH INITIATIVES:
Health promotion in Canada has been largely based on individual lifestyle change and reducing personal risk factors (Schrecker, 2013) yet health promotion messages (anti smoking campaigns, seatbelt legislation, drunk driving legislation, diet and exercise promotion) are better received from more advantaged sectors of society (Glouberman & Millar, 2003).
References
Edwards, N. & Cohen, E. (2012). Joining up action to address social determinants of health and health inequities in Canada. Health Care Management Forum. 25: 151-154. Retrieved from http://journals.sagepub.com/doi/pdf/10.1016/j.hcmf.2012.07.002
Glouberman, S. & Millar, J. (2003). Evolution of the determinants of health, health policy, and health information systems in Canada. American Journal of Public Health. 93(3). 388-391. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447749/
Government of Canada. (2011). What determines health? Retrieved from https://www.canada.ca/en/public-health/services/health-promotion/population-health/what-determines-health.html#determinants
Raphael, D., Curry-Stevens, A., Bryant, T. (2008). Barriers to addressing the social determinants of health: insights from the Canadian experience. Health Policy. 88: 222-235. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/18471923
Schrecker, T. (2013). Beyond “run, knit and relax”: can health promotion in Canada advance the social determinants of health agenda? Health Care Policy. (9)48-58. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4750152/
Smith, N., Mitten, C., & Kershaw, P. (2016). The reallocation challenge: containing Canadian medical care spending to invest in the social determinants of health. Canadian Journal of Public Health. 107(1), 130-132. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/27348100