Week 6- Determinants of Health
When considering health in its broadest sense, it becomes clear that we cannot focus solely on medical care or personal life choices. Instead, we must look at the social determinants of health- described by the Public Health Agency of Canada as the “personal, social, economic and environmental factors that determine individual and population health” (Government of Canada, 2024). These include income, employment conditions, education, early childhood experiences, physical environments, social supports, health behaviours, access to care, biology and genetic influences, gender, culture, and race or racism. These shape not only health outcomes but also a person’s position within society (Government of Canada, 2024).
Experiences of discrimination, racism, bias, and trauma play a significant role in shaping the health of marginalized communities. Although many Canadians assume that health is primarily determined by access to medical services or individual lifestyle choices, the evidence suggests that everyday living and working conditions have the greatest influence (Raphael et al., 2020). These conditions, which are often shaped by government policies, help to determine whether individuals have the r resources, opportunities, and environments needed to live “healthy” lives.
Health equity builds on this understanding. It reflects the principle that every person deserves a fair and equal choice to achieve the best possible health (Sanderson & Singh, nd). Despite this, policies at multiple governmental levels do not always support equitable access to social and material resources. As a result, existing inequities often deepen, widening the gap in health outcomes for underserved populations. While the federal government may initiate broad programs aimed at leveling the fields, the practical responsibility for allocating and distributing resources frequently falls to provincial governments, leading to variability and inconsistencies across regions.
Public health professionals are uniquely positioned to advance health equity. Because their work focuses on the upstream interventions that affect entire populations, public health agencies must consider how their decisions may either reduce or reinforce health inequity. (Sanderson & Singh, nd). Ontario Health reinforces this perspective by defining the social determinants of health (SDoH) as the non-medical conditions in which people live, grow, work, and age, and the wider systems shape these conditions (Ontario Health, 2024). Their framework emphasizes understanding organizational relationships, recognizing power imbalances, collaborating across sectors, and shifting efforts from short-term downstream fixes to long-term upstream solutions (Ontario Health, 2024).
The effects of inequitable social conditions are not just theoretical; they manifest in the body. Chronic stress, often a result of persistent socioeconomic pressures, triggers repeated “fight or flight” responses. Without opportunities for recovery, these stress responses compound and contribute to deteriorating health (Raphael et al, 2020). In this way, inequities in living conditions translate directly into physiological harm.
A nation’s overall health is deeply tied to how it distributes social resources. The policies that make up a country’s welfare state influence the quality of fairness of education, housing, employment, and social supports, all of which shape the social determinants of health (Raphael et al, 2020). Understanding and acting on these connections is essential if we hope to build a society where everyone can experience “good health.”
References
Government of Canada. (2024, July 18). Social determinants of health and health inequalities. Government of Canada. https://www.canada.ca/en/public-health/services/health-promotion/population-health/what-determines-health.html
Health Equity. (n.d.). Public Health Ontario. https://www.publichealthontario.ca/en/health-topics/health-equity
Ontario Health. (2024). Ontario Health’s Social Determinants of Health Framework… A Paradigm Shift What Makes People Sick? https://www.ontariohealth.ca/content/dam/ontariohealth/documents/social-determinants-of-health-framework.pdf
Raphael, D., Bryant, T., Mikkonen, J., & Raphael, A. (2020). Social Determinants of Health: The Canadian Facts (pp. 1–93). https://thecanadianfacts.org/The_Canadian_Facts-2nd_ed.pdf
Resource Guide to Ontario Health’s Social Determinants of Health Framework A Paradigm Shift. (2024). https://www.ontariohealth.ca/content/dam/ontariohealth/documents/social-determinants-of-health%E2%80%93fnimui-resource-guide.pdf
Sanderson, M., & Singh Flora, T. (n.d.). HEALTH EQUITY AND PUBLIC HEALTH IN ONTARIO A Scan of Health Equity Activities Taking Place in Ontario Public Health Units and the Identification of Enablers, Challenges, and Select Examples. https://opha.on.ca/wp-content/uploads/2021/06/Health-Equity-in-Ontario-FULL-REPORT-1.pdf
TheCanadianFacts. (2011). Social Determinants of Health: The Canadian Facts. In YouTube. https://www.youtube.com/watch?v=GMw_7AWEg4A