As a Registered Nurse in Ontario, to say the social determinants of health are imperative to the health of a nation would be correct. Currently the Government of Canada outlines social determinants of health as follows:
1) Income and social status
2) Employment and working conditions
3) Education and literacy
4) Childhood experiences
5) Physical environments
6) Social supports and coping behaviour
7) Healthy behaviours
8) Access to health services
9) Biology and genetic endowment
10) Gender
11) Culture
12) Race/ Racism
After reviewing multiple sources from both federal and provincial Ontario, Canada sources; it becomes obvious how the social determinants of health influences the health of Canadians, government and policy development, and politics. There were four main themes that appeared during my review of resources relating to the social determinants of health. They were:
1) Coping strategies and behaviours
2) Health and health inequalities
3) Health promotion
4) Health policy development
Coping strategies and behaviours apply to the individual and the population. How people function and cope in relation to the social determinants of health that they are exposed to is a very individualistic response. Income, employment, education, culture and race: these all influenced the health of an individual. Whether it is how they perceive their health and their health beliefs, their access to programs such as insurance coverage or knowledge of programs in their area, family supports, etc. Those that have stronger coping mechanisms, support and behaviours have demonstrated better health outcomes.
This leads us into the second theme: health and health inequalities. Much of the public health approach in Ontario strives to overcome health inequalities to provide all Canadians with equal access to healthcare. This is especially seen in Northern Ontario communities and small rural communities. From a nursing perspective we can see these disparities at the bedside, a direct cause and effect on our patients’ health outcomes. The further away from a large medical center a client is – the more negative the impact on the individual’s future health status. This includes acute and preventative care such as: immunizations and other health promotional programs (such as infant, adolescent or elder promoting activities. This leads to the third theme: health promotion. Health promotion from a public health standard focuses on the health of communities, healthy behaviours (such as school programs involving dental, vision and immunizations). Provincial health promotion also involves the surveillance, epidemiology, planning, research, and population health assessment. The federal approach is similar in surveillance and prevention of chronic disease to improve health outcomes of Canadians to avoid use of the acute treatment sector of the health care system in the future.
The final theme that appears is healthy policy development. As an Ontario registered nurse, we can see this approach through the nursing bodies such as the Registered Nurses Association of Ontario (RNAO) and College of Nurses of Ontario (CNO). Both associations lobby the federal and provincial government for a safer working environment and health of nurses (including physical, mental and emotional) as well as the health of the province and client/ patient care and outcomes. These bodies also lobby the government for other issues for example: supporting teaching unions during their fight against provincial education cuts. Health policy development is seen at a provincial level through emergency preparedness, infection and communicable disease control. At a federal level, health promotion includes resolving health disparities as seen largely in the Inuit, Metis and First Nation communities.
Overall, the provincial and federal promotion of social determinants of health varies widely and encompasses numerous programs, monitoring, education and promotions. These roles (although varied) overlap in many aspects to provide Ontario with the upmost in preventative and treatment of their health at a cost effective solution.
Creating a Healthier Canada: Making Prevention a Priority (2010). Retrieved February 13, 2020, from https://www.canada.ca/content/dam/phac-aspc/migration/phac-aspc/hp-ps/hl-mvs/declaration/pdf/dpp-eng.pdf
Ministry of Health and Long-Term Care. Standards for Public Health Programs and Services (2017). Retrieved February 13, 2020, from http://www.oxfordcounty.ca/Portals/15/Documents/Council/Attachments/PHES%20201704%20ATT%201%20Standards%20for%20Public%20Health%20Programs%20and%20Services%20Consultation%20Document.pdf
Ontario Agency for Health Protection and Promotion Act (2007). Retrieved February 13, 2020, from https://www.ontario.ca/laws/statute/07o10/v7
Social determinants of health and health inequalities. Government of Canada (2019). Retrieved February 13, 2020, from https://www.canada.ca/en/public-health/services/health-promotion/population-health/what-determines-health.html
The Integrated Pan-Canadian Healthy Living Strategy (2005). Retrieved February 13, 2020, from https://www.canada.ca/content/dam/phac-aspc/migration/phac-aspc/hp-ps/hl-mvs/ipchls-spimmvs/pdf/ipchls-spimmvs-eng.pdf
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