In last week’s discussion forum, the focus was on the definition of health as per the World Health Organization (WHO) in 1948. While collecting reasons to support the need for the definition to be modernized, I quickly realized that many factors come into play when determining one’s health. While the WHO defined health as being “a state of complete physical, mental, and social well-being and not merely the absence of disease of infirmity” (WHO, 2006), it is clear that health should be a balance between all three factors. In addition to the difficulty in achieving that balance, one has to also consider additional factors that affect one’s health. Determinants of health are the personal, social, economic and environmental factors that determine individual and population health. (Government of Canada, 2020). The main determinants of health include:
Social determinants of health (SDoH) refer to a specific group of social and economic factors within the broader determinants of health. These relate to an individual's place in society, such as income, education or employment. Experiences of discrimination, racism and historical trauma are important social determinants of health for certain groups such as Indigenous Peoples, LGBTQ and Black Canadians. (Government of Canada, 2020).
Taking this all into account, the health of an individual is largely dependent in the community they live in and the resources available. Canada is highly regarded around the world for its healthcare standards and advancements in and technology. Despite the high ranking, this level of healthcare is not provided nationwide due to many social determinants restricting Canadians from achieving optimal health.
This inequitable level of health is predominantly seen amongst the Indigenous Canadian community. Indigenous peoples in Canada represent 4.3% of the total Canadian population. They have a life expectancy 12 years lower than the national average and experience higher rates of preventable chronic diseases compared with non-Indigenous Canadians. (Nader et al., 2015). Understanding the context of SDoH in Canadian Indigenous peoples, requires examining Canadian history after the 1867 Indian Act. Indigenous peoples were forced to give up “status” and heritage, while Indigenous children were taken away from their families and placed into residential schools and non-Indigenous foster families. Due to the abuse experienced in the residential schools, this population of Canadians have shown to demonstrate both psychological and emotional trauma. This is a result of being abused both mentally and physically in residential schools and has contributed to many present health issues such as mental illness, depression, suicide, violence, and sexual, alcohol, and drug related vulnerabilities. (Nader et al., 2015). This is just one example of how culture, childhood experiences, and physical environments can affect an individual as well as community’s health.
On a broader level, wealthier communities often exhibit lower chronic diseases. These communities are outfitted with healthcare facilities with more advanced technologies, access to a broad range of medication, as well as, collectively, are more educated compared to poorer communities. A higher level of education helps to drive an individual to lead a healthier lifestyle and take preventative action to mitigate more serious diseases; this is referred to as health literacy. Having the adequate SDoH in place for children should be the priority of any community. Adverse living conditions not only shape children’s health, but threaten the foundations of health such that the onset of type II diabetes and cardiovascular diseases – among other diseases – during adulthood is firmly related to the experience of childhood adversity. (Raphael, 2012).
In many first world countries, the government takes on the responsibility of assuring access to adequate SDoH. The examples provided make it evident this is not experienced equally across Canada as access to food and housing is not available for all. Family poverty rates are amongst the highest of developed nations, and the evidence indicates that these circumstances leads to adverse health outcomes. Although the social determinants of health are complex and interdependent of one another, the Canadian government needs to ensure a good public policy to provide means of both promoting health in general and reducing health inequalities nationwide. (Canadian Public Health Association, n.d.).
References:
Association, C. P. H. (n.d.). What are the social determinants of health? Canadian Public Health Association | Association Canadienne de Santé Publique. Retrieved February 12, 2022, from https://www.cpha.ca/what-are-social-determinants-health
Canada, P. H. A. of. (2020, October 7). Government of Canada. Social determinants of health and health inequalities - Canada.ca. Retrieved February 12, 2022, from https://www.canada.ca/en/public-health/services/health-promotion/population-health/what-determines-health.html
Nader, F., Kolahdooz, F., Yi, K. J., & Sharma, S. (2015, July 16). Understanding the social determinants of health among indigenous Canadians: Priorities for health promotion policies and actions. Taylor & Francis. Retrieved February 12, 2022, from https://www.tandfonline.com/doi/full/10.3402/gha.v8.27968
Raphael, D. (2012, September 4). Educating the Canadian public about ... - journals.sagepub.com. SAGE Journals. Retrieved February 12, 2022, from https://journals.sagepub.com/doi/full/10.1177/1757975912453847
WHO. (2006, October). Constitution of the world health organization. Constitution of the World Health Organization. Retrieved February 5, 2022, from https://www.who.int/governance/eb/who_constitution_en.pdf
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