Determinants of Health

According to the Government of Canada the determinants of health are broad range of personal, social, economic and environmental factors which determine individual and population health. (Government of Canada/Public Health, n.d.) This includes personal income, social status, education, employment and working conditions, childhood experience, physical environment, social support, healthy behaviors, access to health services, biology and genetic endowment, gender, culture.

Julia Brassolotto and Dennis Raohael in their journal article “Epistemological barriers to addressing the social determinants of health among public health professionals in Ontario, Canada: a qualitative inquiry” interviewed lead medical officers and healthcare professionals from nine public health units and concluded that “Ontario public health units generally neglected the social determinants of health and act on risk aversions and behaviorally oriented health promotion approaches” (Julia Brassolotto, 2013)

Their conclusion was based on the interviews they conducted with the medical professionals of Ontario public health units. They evaluated the public health units’ websites and then sent these public health units a questionnaire and evaluated the answers. After analyzing all the data they concluded that different public health units understood and interpreted the social determinants of health differently and therefore executed their dominant research and practice paradigms differently. Some of the public health units focused on adverse living conditions and develop and execute programs to help individuals with adverse living conditions, and the authors categorized them as a group with “functional “approach.

Some other public health units analysed how the adverse living conditions determine the health and then carry out analysis about different living conditions. The authors categorized them as a group with “analytical” approach.

The third public health group identified and analysed how the public health policies are made and how these decisions impact health and identify the political and social approaches to addressing the determinants of health. The authors identified them as a group with a “structural “approach.

Even though all the public health units addressed and understood the health determinates according to their own views and beliefs, the authors recognized that in order to address the health determinants in Ontario, the province should centralized the Social determinants of health care leadership, as well as in cooperating research to address the politics of health in a meaningful way (Julia Brassolotto, 2013) and finally educating multiple levels of health authorities about the value of informed decision making.

Julia Brassolotto’s conclusions of Ontario health determinants status which is that Ontario is lacking a centralized health determinants address plan is identical to Sholom Glouberman and John Millar’s conclusion in their “Evolution of the Determinants of Health, Health Policy, and Health Information Systems in Canada” They explain and evaluate the Canadian government approach to the determinants of health care and acknowledge that the government took a health promotion approach to address some of the determinants of health. Introduction of social policies, education and restrictions to avoid risk factors, for example as a result of health education messages and restrictions on advertising, the national smoking rate dropped from approximately 50% to approximately 25%.8 • New legislation increased the use of seat belts and bicycle and motorcycle helmets. (Sholom Glouberman, 2003)

However Sholom further explains that over the past decade more attention was given to the cost of the Health care and the public health dialog has taken a cost saving route, rather than addressing the health determinants and emerging health issues. He raised concerns over that emerging unsolved health issues like poverty, epidemic obesity, and Aboriginal health issues and highlights that Canada is far behind in comparison to some European countries like Sweden and United Kingdom in addressing the health determinants.

References

Brassolotto, J., Raphael, D., & Baldeo, N. (2013). Epistemological barriers to addressing the social determinants of health among public health professionals in Ontario, Canada: A qualitative inquiry. Critical Public Health, 24(3), 321-336. doi:10.1080/09581596.2013.820256.

Public Health Agency of Canada. (2019, June 04). Public Health Agency of Canada. Retrieved from https://www.canada.ca/en/public-health.html

Glouberman, S., & Millar, J. (2003). Evolution of the Determinants of Health, Health Policy, and Health Information Systems in Canada. American Journal of Public Health, 93(3), 388-392. doi:10.2105/ajph.93.3.388