Health Equity and Social Determinants of Health

Health Equity – Let’s Start a Conversation About Health....

What determines health? Many people think of their health as a result of personal choices they make such as choosing to eat more fruits and vegetables, being active for at least 30 minutes or more, choosing not to smoke, or drinking alcohol in moderation. Others believe that seeing a health professional promptly for medical care when it is needed is what makes them healthy.

New information says that health is affected by much more than that. It is a result of everything that we do... where we live, learn, work, and play. These conditions are called determinants of health. Below are the determinants of health listed by the Canadian Public Health Agency.

Income and Income Distribution
Education
Unemployment and Job Security
Employment and Working Conditions
Early Childhood Development
Food Insecurity
Housing
Social Exclusion
Social Safety Network
Health Services
Aboriginal Status
Gender
Race
Disability

Adapted from the CPHA - Canadian Public Health Association

Grey Bruce Health Unit Collaborations

Income Disparity

...none of these compares to the way that poverty makes us sick. Prescribing medications and lifestyle changes for our patients who suffer from income deficiency isn’t enough; we need to start prescribing healthy incomes.
Toronto Star, Basic income: just what the doctor ordered

The direct cost of chronic diseases accounts for about 58% of the annual health care spending in our country… up to 80% were seen to improve as family income increases.
CDPAC, Social Determinants of Health

Poorer people in cities with more equal sharing of income, are healthier and live longer than richer people in cities with less sharing of income.
James R. Dunn, PhD, The Health Determinants Partnership Making Connections Project (p16)

How much are resources shared in the community you live in?

Housing

Safe and affordable housing is an absolute necessity for living a healthy life. The presence of mould, poor heating, inadequate ventilation, pests and overcrowding are all determinants of adverse health outcomes. Children who live in low quality housing condition have a greater likelihood of poor health outcomes as children and also later in adulthood.
The Canadian Facts, Social Determinants of Health

Housing is unaffordable when it costs more than 30% of your income. As a result, it is difficult to purchase other necessities such as food, transit, clothing and essentials.
CMHC, About Affordable Housing in Canada

Also see Infographic: Federal Investment in Affordable Housing

Food Security

Food insecurity is significantly associated with poor health outcomes including multiple chronic conditions, obesity, distress and depression.
NCBI, Food insecurity in Canadian households

Food insecurity also “has negative consequences for children’s physical development, and may result in behavioural and developmental problems” (Best SRC, 2010).
Nutritious Food Basket Survey 2015

Also see the Ontario Student Nutrition Program

Transportation

Public transport should be improved for longer journeys, with regular and frequent connections for rural areas….Incentives need to be changed, for example, by reducing state subsidies for road building, increasing financial support for public transport
WHO, Social Determinants of Health: The Solid Facts (p 29)

Expand to Discover More Social Determinants of Health

Aboriginal Status

Health Inequities and Social Determinants of Aboriginal Peoples Health Booklet

First Nations, Metis, and Inuit peoples constitute 3.8 % of the Canadian population. The average income of Aboriginal men and women is 58% less than the rest of Canadians. Unemployment rates are higher. Of all First Nations people living on reserve, 40% men, 43% women attain high school education.
NCCAH, Health Inequalities and Social Determinants of Aboriginal Peoples' Health

Aboriginal peoples are more likely to be living in crowded housing than non-Aboriginal Canadians. Rates of infectious and chronic diseases are much higher in the Aboriginal population than the rest of Canadians. Suicide rates, addiction rates, and childhood sexual assault are much higher than the rest of Canada.
Social Determinants of Health - The Canadian Facts

Recommendations of the 2015 Truth and Reconciliation Report need to be followed to address the social determinants of health affected all Aboriginal Peoples. See Truth and Reconciliation Commission of Canada: Calls to Action

Social Safety Net

This refers to a range of benefits, programs and supports that protect citizens during various life changes that can affect their health. These life changes could be normal things such as having and raising children, reaching retirement, or could be unexpected events such as having an accident, unemployment, or getting sick. More information on Social Safety Net can be found within Social Determinants of Health - The Canadian Facts.

Thinking differently about building a healthy society

Why Canadian babies don’t sleep in boxes.

Early Childhood Development

Children born into socioeconomically disadvantaged families suffer worse child well-being and its lifelong implications, in all societies…less to do with specific welfare policies or targeted interventions for poor children than to a societal commitment to greater equality.
The Ethical and Policy Implications of Research on Income Inequality and Child Well-Being

There is a growing gap in those kids living in circumstances where the parents don’t or can’t spend that time reading, a growing gap in ‘Goodnight Moon’ time.… Smart, poor kids with high test scores are now less likely to graduate from college than not-so-smart rich kids with low test scores.
Get Schooled, Goodnight Moon and opportunity: A worrisome gap between rich and poor

The early years of life are crucial in influencing a range of health and social outcomes across the life course…the loss of human potential … is associated with more than a 20% deficit in adult income and will have implications for national development
Promoting equity from the start through early child development and Health in All Policies

Children who participate in quality early childhood development (pre-school) programs have significantly better socioeconomic, educational, and emotional developmental outcomes.
CDPAC Position Statement on Social Determinants of Health.

Living and Working Conditions

Employment features that shape health outcomes: employment security, physical conditions at work, work pace and stress, working hours, opportunity for self-expression and development. When workers feel an imbalance between demands and rewards, it leads to health problems.
Social Determinants of Health - The Canadian Facts

What are my rights as an employee?

In Canada, workplace injuries are under-reported as there are costs to employers and employees to report these accidents. 30% of employees feel their employment puts their health and safety at risk.

Employment, job security and working conditions:

Gender

Researching for LGBTQ for health

Health Equity and Social Determinants of Health

Impact of Determinants on Health Outcomes

Why is Jason in the hospital?
Because he has a bad infection in his leg.
But why does he have an infection?
The full Story...

View the complete article What Makes Canadians Healthy or Unhealthy?

Grey Bruce Community Picture

The Grey Bruce Community Picture. The 2014 supplement, describes and puts into context each determinant of health (pp 26 – 41).

The Bruce Grey Poverty Task Force

Visit the website for the Grey Bruce Poverty Task Force for more information.

Vision:

The Poverty Task Force will reduce and eliminate poverty in our community.

Purpose:

The Poverty Task Force facilitates community partnerships to advocate for poverty reduction and elimination.

Values:

Collaboration/Partnership
- Building trust and respect across community stakeholders through dialogue and purposeful partnerships.
Understanding poverty issues and each other
- Working together to educate each other, share creative solutions and develop a common understanding of issues related to poverty.
Equality/Justice
- Working to improve lives within the community, while ensuring the services are accessible, affordable, humanitarian, equitable, and provides choice.
Advocacy
- Acting in partnership to leverage our community knowledge and expertise to advocate for change.
Com(passion) for Change
- Acting with compassion to make meaningful change for individuals and families when they need it most.
Collective Synergies
- Recognizing that our collective energies are greater than that of any individual. Individually we can do little, together we can move mountains.

Strategic Directions

Build partnerships with key community stakeholders and networks and work together to eliminate poverty.
Enhance our common understanding of poverty issues through solution-based research, knowledge development and information sharing.
Create opportunities for community stakeholders to become involved in poverty elimination efforts.