Summary of Key Points; Health Inequalities and the Social Determinants of Health

As a Registered Social Worker on an inpatient mental health unit, I often experience how the social determinants of health may negatively influence the successful health outcomes among people who are the most marginalized in society. The Government Of Canada identifies 12 main determinants of health and defines the social determinants of health as, “a broad range of personal, social, economic and environmental factors that determine individual and population of health.” (Government of Canada, n.d.). Of these 12 main determinants, I often encounter how gender, culture, race, income, education level, and childhood experiences have effected patients, and contributed towards patients being exposed to health inequalities. Examples from my experience are inability to obtain identification, misdiagnosis, lack of available mental health supports, and discrimination and racism. Despite Canada being one of the healthiest countries in the world, some of its citizens have more access than others to opportunities to lead a heathy life. (Government of Canada, n.d.) The Government of Canada’s strategy to reduce health inequalities entails helping to provide equal opportunities for Canadians to become healthy, regardless of where they live, or who they are. They intend on doing this by using specific data tools related to marginalized populations to strengthen an evidence base to inform decision making (Government of Canada, n.d.). Moreover, they aspire to engage beyond the health sector, and establish a Canadian Council on social determinants of health to engage with leaders from various social determinants of health sectors; whilst sharing knowledge of action across Canada. Through these initiatives, the federal government is acting on transparency and commitment; while involving key stakeholders in making important decisions towards improving health outcomes of Canadians.

Alberta Health Services (AHS) has acknowledged how sometimes the most important influences such as the social determinants of health are not the first thing identified in terms of treatment planning and understanding a person’s diagnosis or illness. Subsequently, AHS has developed approaches to incorporate the importance of the social determinants of health in patient and client care. These specific approaches are the Healthy Communities Approach (HCA) and the establishing of a province wide social determinants of health and health equity approach to care. The HCA identifies three levels of importance to focus on when attempting to improve people’s health and to remove inequalities: Individual, Community, and Policy; all the while, identifying the interconnection of these factors. (Alberta Health Services, 2022). The establishing of a province wide approach to the social determinants of health and health equity by AHS, identifies leadership as an important factor in advancing health equity, and included health equity as a strategic priority for the organization (NCCDH, 2013). Subsequently, a portfolio specific to health equity was created by AHS, with members from executive and medical offices included. Similar to the government of Canada’s approach to support the reduction of health inequalities, and recognize the importance of the social determinants of health, AHS’s province wide health equity strategy includes capturing the right evidence to ensure the strongest arguments possible are built for a health equity approach, in addition to a range of evidence based data was collected (NCCDH, 2013).

As per Andermann (2016), responsibly addressing the importance of the social determinants of health requires a diversity of action from many sectors; alas, physicians and additional allied health care staff at the frontlines of clinical care are imperative players and potential catalysts of change for patients on a micro level at first. That being said, the involvement of front line staff to support their patients in undertaking social challenges raises awareness of the importance of the social determinants of health and increases potential for advocacy and efforts to scale back health inequities and to shift change for additional responsive health and social systems. Leaders in Canadian health care have progressively acknowledged the requirements for a social determinants and population health approach minimizing the demand and improving overall sustainability of the health system (Andermann, 2016). To summarize, these articles and resources identify the importance of change and inclusion on the individual, community, and policy level; in addition to the importance of sharing the information learned and process with citizens. It appears significant strides have been made with regard to awareness and importance of health inequities and the social determinants of health; albeit, I query with the broad range and scope between Canada’s social determinants of health, are we minimizing the potential for fortitude if combined.

Alberta Health Services. (2022). albertahealthycommunities. What Determines Health?

https://albertahealthycommunities.healthiertogether.ca/about/what-determines-health/

Andermann, A. (2016). Taking action on the social determinants of health in clinical practice: A

framework for health professionals. Cmaj, 188(17–18), E474–E483.

https://doi.org/10.1503/cmaj.160177

Government of Canada. (n.d.). Social determinants of health and health inequalities. Retrieved

February 9, 2022, from https://www.canada.ca/en/public-health/services/health-

promotion/population-health/what-determines-health.html

NCCDH. (2013). Leadership for Health Equity: Alberta Health Services - Establishing a Province-

Wide Social Determinants of Health and Health Equity Approach.

http://nccdh.ca/resources/entry/alberta-health-service