I had a bit of a humbling 'ah ha' moment during this week's curation of resources relating to the determinants of health. I was incorrectly using the terms "determinants of health" and "social determinants of heath" synonymously. Who knew? -Well, I do now!
It wasn't until this critical exploration that I broadened and clarified my understanding of not only the differences between the terms, but also their application. See below for my key learnings from this week's resource curation activity.
What Have I Learned?
The Government of Canada lists 12 broad Determinants of health which determine individual and population health based on personal, social, economic and environmental factors (2022). There are determinants of health in which individuals have no control over (e.g. biology and genetic endowment, race, etc.) and other factors in which some individuals may have varying degrees of influence over, such as healthy behaviors, education, and income.
On the other hand, the Social determinants of health are specific to social and economic factors impacting health. In a model cited by Mikkonen and Raphael, there are 14 social determinants of health that have a strong impact on the health of Canadians (2010). When I compare this to the list of 12 determinants of health from the Government of Canada, I observe that for many the social determinants of health would be associated with a persons' life circumstance or situation, and the environment in which they live; things that are often outside of individual control, especially for vulnerable populations. These are the determinants where I see health promotion, population public health and preventative healthcare lending incredible value and an important role in our health system.
From my review it appears that within my own province, Alberta Health Services cites the same Determinants of health within their Population Health Promotion Program. This is the area which delivers provincial programs and initiatives such as Injury Prevention, Health Equity, and Poverty Reduction Initiatives (n.d.).
There are a number of helpful examples from the Canadian Public Health Association (CPHA) which draw connection between how each social determinant of health relates to the health of an individual or population. One example is that with higher levels of education an individual may have more opportunity to a stable job, which in turn that job could include health insurance for services that are not covered by government health programs (n.d.). This stands out to me as it relates back to our Week 4 lesson on the Canada Health Act, as health insurance is important to provide affordable medication and treatments not covered by Medicare for Canadians. From what I have explored this week, including reviewing my peers reflections, the determinants of health (including social factors) play a critical role in how we as health professionals can effectively influence the broader health system towards improving both individual and population health.
Why Does it Matter?
Common language is important to effectively collaborate with other professionals and deliver health services, as well as to competently review and translate literature into practice. -this includes my new founded clarity on the difference between determinants and social determinants of health. Beyond just understanding the Determinants of health, it is valuable to be mindful of how we're communicating them. For example, Churchill et al. published a study in 2021 where they tested different messaging with Ontario residents about the social determinants of health. Their goal was to improve public understanding of the social and economic factors which impact health inequities, because public interest can drive government (and thus policy) action. This is one example which highlights why understanding, researching and communicating the Social Determinants of Health is important.
What do you think about how we communicate the determinants of health?
(and was anyone else using the two terms synonymously??)
- Kylie
References (also included within the Resources tab of this ePortfolio)
Alberta Health Services. (n.d.). Population Health Promotion Program. https://www.albertahealthservices.ca/findhealth/service.aspx?Id=3677
Canadian Public Health Association. (n.d.) What are the social determinants of health? . https://www.cpha.ca/what-are-social-determinants-health
Churchill, E., Shankardass, K., Perrella, A. M. L., Lofters, A., Quiñonez, C., Brooks, L., Wilson, D., & Kirst, M. (2021). Effectiveness of Narrative Messaging Styles about the Social Determinants of Health and Health Inequities in Ontario, Canada. International Journal of Environmental Research and Public Health, 18(20), 10881. https://doi.org/10.3390/ijerph182010881
Government of Canada. (2022, June 14). [Government]. Social Determinants of Health and Health Inequalities. https://www.canada.ca/en/public-health/services/health-promotion/population-health/what-determines-health.html
Mikkonen, J., & Raphael, D. (2010). Social Determinants of Health: The Canadian Facts. Toronto, Canada: York University School of Health Policy and Management. https://nccdh.ca/resources/entry/social-determinants-of-health-the-canadian-facts
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