on August 27, 2008
This volume updates and extends the analysis of the state of various social determinants of health in Canada contained in the 1st edition of Social Determinants of Health: Canadian Perspectives. This work represents a unique undertaking in the social determinants of health area in that it brings together scholarship by those working in early childhood education and care, education and literacy, employment and working conditions, food security, gender, health services, housing, income and its distribution, social exclusion, the social safety net, and unemployment and job insecurity with work by those specifically focused on the health effects of these issues.
The 1st edition of Social Determinants of Health: Canadian Perspectives aimed to foster communication between those concerned with the current state of various social determinants of health and those knowledgeable about their health effects. Clearly the work contributed to this goal. The close to 8,000 copies of the work sold reached a wide range of sectors both inside and outside of academia. It contributed to the increasing diffusion of the social determinants of health concept into discussion of a wide range of issues. It is now common to find mention of the health-related effects of lack of child care, continuing income, housing, and food insecurity, inadequate social and health services, and other social determinants of health in a wide range of documents, reports, and related advocacy efforts.
The social determinants of health concept has been taken up by pioneering public health units across Canada striving to shift the discussion of health away from biomedical and behavioural risks towards emphasizing living conditions as the primary determinants of individual and population health. United Ways of Canada, Social Planning Councils, and numerous other agencies concerned with striving to improve the quality of life of Canadians now draw upon the social determinants of health concept in their activities.
Yet for all of this increased discussion of the social determinants of health concept, there is precious little to show of its effects upon the development of public policy in Canada. There is little evidence that policymakers draw upon these concepts - and related research findings -- to create health promoting public policy. Media coverage of health issues continues to be dominated by biomedical and behavioural approaches and not surprisingly, public understandings of the determinants of health mirror these preoccupations. Clearly there is a continuing need to present the social determinants of health message.
The 2nd edition continues to raise these issues. There is greater attention paid to the ideological barriers to having these issues addressed by those working in the health field and the makers of public policy. In addition to the updating of the material presented in the chapter, new or newly authored chapters focus on:
* the pathways and mechanisms that explain how social determinants of health come to shape health
* early childhood and how a range of factors shape children' health
* the complexity of Aboriginal Health and its determinants
* the health care system and how it serves as a social determinant of health
* public policy and the social safety net
* public policy and gender.
As before, the aim of Social Determinants of Health: Canadian Perspectives is to promote more accurate public understandings and more mature public policymaking in the support of health. These have clearly proven to be difficult tasks to accomplish in Canada. This has not been the case in many other nations. It is reassuring - though frustrating -- to note that the social determinants of health concept has taken root and been nurtured in many European nations such that public policy in the service of health is increasingly common. Hopefully, this volume will help to narrow the gap between Canadian action on the social determinants of health and those seen in other nations.