Social Determinants of Health in Canada- Getting to the Root Causes of Disease

This week’s tasks in MHST601 involves curating resources on the determinants of health, with a focus on both the federal and provincial levels in Canada. I gathered many great resources which can be found and summarized here. But, I'd like to take a moment to focus on a particular journal article by Dennis Raphael. He is a professor at the School of Health Policy and Management at York University, with many publications focusing on poverty and the social determinants of health (York University, n.d.).

Raphael (2003) reviews and critiques Ontario public health units’ ability to address the social determinants of health and poverty of their regions. The article argues that the downstream approaches and behavior-modifying strategies currently in place for heart health promotion (including smoking cessation, diet, and activity) are inefficient. He reviews evidence that these methods are drawing attention away from the root causes such as the social determinants of health and poverty, while placing blame on the individuals rather than the systemic issues at hand. In addition, Raphael explains that downstream approaches in public health can widen the gap between the public’s knowledge and understanding of SDH such as poverty, and the influence they inevitably hold on individuals’ health. Thus, policy change and development continue to be put on the backburner by our primarily conservative Ontario government over the years.

Further, Raphael (2003) highlights the forward strategies adapted by Waterloo Regional Health Unit and Lanark, Leeds and Grenville Public Health Unit. Both public health units have adopted preventative methods to raise awareness and address the SDH at the forefront of health promotion. Raphael (2003) concludes by providing the following suggestions:

At the municipal level, health impact analyses could assess the effects of user fees for libraries, recreation and park services, and increases in public transportation fares. At the provincial level, analyses of the impact upon health of reducing social assistance rates, eliminating new social housing and rent control, and providing transfers of money from the poor to the wealthy through income tax reductions could be undertaken. (p.403)

Raphael believes that if adopted by policy-makers, these proposals would benefit public health promotion by truly addressing the root causes of heart disease, such as poverty and other social determinants of health.

References

Raphael, D. (2003, December 01). Barriers to addressing the societal determinants of Health:

Public health units and poverty in Ontario, Canada. Health Promotion International,

18(4), 397–405. https://doi.org/10.1093/heapro/dag411

York University. (n.d.). Dennis Raphael- Faculty of Health. York University.

https://health.yorku.ca/health-profiles/index.php?mid=162284