A top priority for the Government of Canada is using a social determinants approach to generate data sets, write reports, and create policies that focus on the framework for health. The key factors that determine health status include lifestyle, environment, human biology, and health services (Government of Canada, 2013). Canada's commitment to reducing health inequities is acknowledged by signing the Rio Political Declaration on Social Determinants of Health (World Health Organization, 2011). The World Conference on Social Determinants of Health was held in Rio, Brazil on October 21, 2011 (World Health Organization, 2011). The objective was to encourage countries to develop national action plans and strategies with "all for equity" and "health for all" in mind (World Health Organization, 2011). The pledges that stood out the most to me were the following (World Health Organization, 2011):
1) Develop inclusive policies that pay attention to vulnerable groups.
2) Adopt better governance for health and development.
3) Aim to reduce health inequities.
4) Strengthen global governance and collaboration.
The main message is “good health requires a universal, comprehensive, equitable, effective, responsive and accessible quality health system.” (World Health Organization, 2011).
Differences in health outcomes between various populations within Canada are largely attributed to social determinants of health. The twelve broad categories of health determinants for Canadians are (Government of Canada, 2020):
1) Race 2) Social supports, coping skills 3) Physical environments
4) Employment, work conditions 5) Education and literacy 6) Income and social status
7) Biology, genetic endowment 8) Childhood experiences 9) Gender
10) Culture 11) Access to health services 12) Healthy behaviours
Indigenous Peoples, members of the LGBTQ community, and Black Canadians are vulnerable populations due to experiences of discrimination, racism, and historical trauma (Government of Canada, 2013). A statement that peaked my interest from the Government of Canada (2013) was "Low-income Canadians are more likely to die earlier and to suffer more illnesses than Canadians with higher incomes, regardless of age, sex, race, and place of residence." The reason for poorer health outcomes in lower income brackets was not as simple as living in poorer conditions; In other words, even if the physical environment was the same, people living in the area that had lower income were more likely to become unhealthy or die younger (Government of Canada, 2013). Evidence was also provided about stress increasing the risk of disease via immune and hormonal systems (Government of Canada, 2013). Perhaps lower income people have more financial stressors that lead to poor coping techniques.
The Government of British Columbia (B.C.) has commented on homelessness, poverty, vulnerable and marginalized populations (Government of British Columbia, n.d). B.C.-specific concerns predominantly belong in the categories of socio-economic circumstances, housing, integration and collaboration in the delivery of social services, education and literacy, and new Canadian populations (Government of British Columbia, n.d.). The University of British Columbia (UBC) has many people working on these major issues. Video 1 from the UBC Medicine-Educational Media features UBC professors who emphasize the importance of prevention instead of simply reacting once a person ultimately becomes sick (McLeod, 2017). They explain the significance of our environment and childhood to our health in adulthood as well as the negative impacts of cumulated stress over time (McLeod, 2017). The quote that resonated the most with me was from Paul Kershaw from the UBC School of Population and Public Health (McLeod, 2017):
"I'm constantly trying to find the right balance between making sure society pays attention to our last great answer while simultaneously pursuing where the research leads in terms of answering the next great question."
Video 1. The Social Determinants of Health
The At Home/Chez Soi Project is mentioned in Video 1 as being a success from research, social, and political perspectives (McLeod, 2017). This project is the largest of its kind in the world, examining 5 cities in Canada in terms of providing housing and support services for people with a history of homelessness (McLeod, 2017). $600 million were used to address the homelessness issue based on the results of the project. Overall, we must continue to strengthen the evidence base to inform decision making (Government of Canada, 2020). By improving the social, physical, relational, and institutional context, we can influence people's capacity to make healthy decisions (McLeod, 2017).
Government of British Columbia. (n.d.) Social determinants of health. Retrieved from
Government of Canada. (2020, October 7). Social determinants of health and health inequities. Retrieved from https://www.canada.ca/en/public-health/services/health-
Government of Canada. (2013, January 15). What makes Canadians healthy or unhealthy?
Retrieved from https://www.canada.ca/en/public-health/services/health-
McLeod, C. [UBC Medicine-Educational Media]. (2017, January 13). The social determinants of
health [Video]. YouTube. https://www.youtube.com/watch?v=nTqknri15fQ
World Health Organization. (2011, October 21). Rio Political Declaration on Social Determinants of Health. Retrieved from https://www.who.int/sdhconference/declaration/
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