Often wonder what determines and impacts our health? According to the Government of Canada, health of Canadian society is influenced by a larger range of four main health determinants “personal, social, economic and environmental” (2020). These four groups include twelve main determinants of health and they are, “Income and social status; Employment and working conditions; education and literacy; childhood experiences; physical environments; social support and coping skills; health behaviours; access to health services; biology and genetic endowment; gender; culture; and race/racism” (Government of Canada [GOC], 2020).
Within the twelve determinants are those pertinent to population’s social and economic factors. These determinants influence one’s living environment, societal status, economic and educational means and accessibility (GOC, 2020). These twelve determinants address different communities part of the bigger society such as, Indigenous peoples, children and members of visible minorities (GOC, 2020). It is rather interesting for the government of Canada to report Canadians as one of the healthiest countries, knowing that health is directly impacted by poverty and economic means. According to Statistics Canada, eleven percent of Canadian populations lives in poverty in the year two-thousand and eighteen, and 12.7% living with no permanent housing arrangements (2020). Moreover, there are 8.7% of Canadians reporting food insecurity and 11.2% with lack of healthcare services accessibility when needed during (Statistics Canada, 2020). However, it would be interesting to learn about housing, food, and healthcare insecurities and lack of accessibility growing over the COVID-19 pandemic era.
When examining the twelve determinants of health, it appears that several fall under the modifiable umbrella, with accessibility risk factors that can be mitigated by governing parties, healthcare advocacy and community engagement. Among those modifiable factors are, housing and healthy food securities, rural and remote healthcare accessibility (GOC, 2020). Furthermore, To support health inequity mitigation in Canada, Government of Canada set a multi-faceted approach through supporting policy making with statistical-based tools, creating the Canadian Council on Social Determinants of Health as a networking platform to match policy-maker’s resources, and sharing achievements and experiences while working as a nation toward meeting the Rio Political Declaration on Social Determinants of Health, a pledge made by Canada and other World Health Organization member countries to mitigate health inequities (GOC, 2020).
During a state of global pandemic, Ontario was among the most negatively impacted Canadian provinces in light of high COVID-19 recorded cases and over populated cities. To address Ontario community’s requests to investigate the correlation of COVID-19 and social determinants of health in Ontario, Public Health Ontario published the “Inequitable Burden of COVID-19 Exposure at Work: The Occupational Exposure to COVID-19 Risk Tool” to shed light on health inequities and its correlation to COVID-19 cases and exposure (2020). Unsurprisingly, Ontario’s most diverse neighbourhoods were the ones with most recorded COVID-19 cases, as well as individuals from visible minorities; immigrant and refugees and lowest house hold income bracket (Public Health Ontario, 2020). In addition to the aforementioned socioeconomic risk factors, Ontarians working in blue collar and women-dominant occupations, often requiring physical proximity, were found to report higher incidence of cases (Public Health Ontario, 2020).
In a literature review conducted by Andermann (2016), to develop an inquiry-informed framework that can be facilitated by healthcare professionals in clinical practice to address social determinants of health. Social determinants of health’s impact on health outcomes was investigated among disempowered socioeconomic population groups (Andermann, 2016). With a conventional medical framework set to address disease prevention, such as, accessibility to poor food and lifestyle choices e.g. smoking, while overlooking the need for healthier choice accessibility; healthcare providers are at an advantage in promoting disease prevention and health promotion in their current frame of work (Andermann, 2016). To facilitate a health determinant- supportive framework in clinical practice, culturally safe and holistic practice spaces would enhance patient engagement and reciprocation in their care (Andermann, 2016). Moreover, partnering with local and public health units in supporting policy review and development, would benefit patients and communities through enabling patients, healthcare providers, and community input in health stewardship.
Andermann (2016) concluded that, primary care providers would benefit from the training and education to identify, address and match their patient’s social determinant inequities and needs to available supporting resources. Among the tools that can aid primary healthcare providers in matching patient’s health needs to resources, is facilitating practice kits developed to flag patients and match them to resources supportive of their current health status and outcomes (Andermann, 2016). Some of those tools are kits addressing vulnerable communities such as, immigrants and refugees, 2SLGBTQ+ community members, Indigenous peoples, individuals with developmental disabilities, and adolescents who are pregnant, children, individuals living with housing or economic insecurities (Andermann, 2016). In conclusion, social determinants of health are guiding factors that provides a guide for health policy makers and public health agencies to promote communities’ health needs and mitigate inequities.
References
Andermann, A. (2016). Taking action on the social determinants of health in clinical practice: a framework for healthcare professionals. Canadian Medical Association v Journal, 188 (17-18), E474-E483. doi: 10.1503/cmaj.160177
Government of Canada. (2020). Social determinants of health and health inequalities. Retrieved from https://www.canada.ca/en/public- health/services/health- promotion/population- health/what-determines- health.html
Public Health Ontario. (2020). Inequitable Burden of COVID-19 Exposure at Work: The Occupational Exposure to COVID-19 Risk Tool. Retrieved from
https://www.publichealthontario.ca/-/media/event-presentations/2021/covid-19-rounds-
inequitable-risk-of-exposure-at-work.pdf?la=en
Statistics Canada. (2020). Dimensions of Poverty Hub. Retrieved from
https://www.statcan.gc.ca/eng/topics-start/poverty
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