The World Health Organization (WHO, 2018) indicate that the social determinants of health are, “the conditions in which people are born, grow, live, work and age. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels… and are mostly responsible for health inequities – the unfair and avoidable differences in health status seen within and between countries” (WHO, 2018).
As a learning activity during the sixth week in the MHST/NURS601: Philosophical Foundations of Health Systems course the class was required to find resources around determinants of health. One resource was to outline the determinants of health of Canadians at the federal level and some resources from the province level where the student lived (for me this would be Ontario).
The following are key points from the resources I found on the determinants of health at the federal and provincial level, as well as an additional resource at the municipal level of where I live.
Federal Level
Government of Canada
The government of Canada recognizes that the national health research infrastructure needs to be reorganized in order to answer questions regarding difficult health issues, however health research is only part of the solution; the big picture is to examine factors both inside and outside the health cared system that affect ones health (“What Determines Health, 2011).
“At every stage of life, health is determined by complex interactions between social and economic factors, the physical environment and individual behaviour…. refereed to as determinants of health. They do not exist in isolation from each other. It is the combined influence of the determinants of health that determine health status” (“What Determines Health, 2011).
The key determinants are:
- 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
- Biological and Genetic Endowment
- Health Services
- Gender
- Culture
A population health approach is needed in order to take action on the complex interactions between the factors that contribute to health and requires:
- Focus on the root cause of a problem with evidence to support the strategy to address it
- Efforts to prevent the problem
- Improving aggregate health status of the whole society, while considering the special
needs and vulnerabilities of sub-populations
- A focus on partnerships and intersectoral cooperation
- Finding flexible and multidimensional solutions for complex problems
- Public involvement and community participation
Provincial Level
Government of Ontario
A new conversation about health in Ontario is needed that involves every government ministry and stakeholder, every community leader and Ontarian. This conversation needs to start with a clear understanding among all parties that the factors which influence health (the social determinants of health) and the ways through which we can improve health, lies for the most part outside of the traditional health care and health promotion sectors (“Health, Not Health Care-Changing the Conversation”, 2010).
“The health care system in Ontario cannot be solely responsible for improving the overall health of our population” (“Health, Not Health Care-Changing the Conversation”, 2010).
Having good health starts long before one visits the doctor, it starts from childhood, in our homes, schools, workplaces and communities. The health care system exists to help people after they get sick or injured. “This conversation needs to be about giving Ontarians a head start on good health, and preventing them from getting sick or injured in the first place (“Health, Not Health Care-Changing the Conversation”, 2010).
Public Health Ontario
The following shows the differences in the demographics of Ontario’s population (which impact health). These determinants of health play an important role in the health status of the Ontario population as a whole.
If we are able to understand these determinants and how they change over time, it can help to meet the health needs of Ontarians (“Ontario’s Population’s Determinants of Health”, 2014).
Municipal Level
Region of Peel
“The cause of the causes of disease are termed the determinants of health” (“Health in Peel- Determinants and Disparities”, 2011).
Definition of determinants of health: “Good or poor health is determined by a variety of factors and influences. To a great extent, people’s behaviours and the conditions in which they are born, grow, work and age strongly influence their health. At every stage of life, health is determined by complex interactions between genetic, social and economic factors; the physical and social environments; and individual behaviour. Factors such as access and use of health services, albeit important, often have less of an impact on health status. All of these factor are referred to as determinants of health” (“Health in Peel- Determinants and Disparities”, 2011).
Here are some information on a couple of the determinants of health in the Peel region, using Peel data:
- Genetics – Age and Sex: the biological effects of aging varies from person to person,
however it is unclear how much the decline is attributable to biological effects and how
much is due to other determinants including personal health practices, social support
and the physical environment. Peel has a higher proportion of adults of reproductive age
and children (“Health in Peel- Determinants and Disparities”, 2011)
- Social Status and income: determines the quality of childhood, education, working
conditions, housing and food security. The likelihood of suffering from chronic diseases
such as cancer and coronary heart disease is higher as you move down each level of the
job status hierarchy. Peel’s low-income prevalence rates are similar to Ontario (“Health
in Peel- Determinants and Disparities”, 2011).
- Education: educational attainment is highly associated with a higher physical and
psychological well-being as well as healthier patterns of behaviour. The proportion of
smokers is 54% higher among those with less than a high school education compared to
those with postsecondary education (“Health in Peel- Determinants and Disparities”,
2011).
What are some resources of determinants of health in your region?
Resources:
“What Determines Health”. (2011). Government of Canada. Retrieved from https://www.canada.ca/en/public-health/services/health-promotion/population-health/what-determines-health.html
“Health, Not Health Care-Changing the Conversation”. (2010). Government of Ontario. Retrieved from http://www.health.gov.on.ca/en/common/ministry/publications/reports/cmoh_10/cmoh_10.pdf
“Ontario’s Population’s Determinants of Health”. (2014). Public Health Ontario. Retrieved from https://www.publichealthontario.ca/en/eRepository/OHP_infog_Population_2014.pdf.
“Health in Peel- Determinants and Disparities”. (2011). Regional of Peel. Retrieved from https://www.peelregion.ca/health/health-status-report/determinants/pdf/MOH-0036_Determinants_final.pdf.
World Health Organization. (2018)
Comments