Lunenburg Part 2 - Section 5 - Social Vulnerability - August 30.pdf

Social Determinants of Health in Canada
Public Health Agency of Canada. “What Makes Canadians Healthy or Unhealthy?”, 2003.
This Government of Canada website provides an explanation of the social determinants of
heath, explaining the underlying premises and providing evidence. The key determinants
identified by the Public Health Agency of Canada are: income; social support networks;
education and literacy; employment and working conditions; social environments; physical
environments; personal health practice and coping skills; healthy child development; biology and
genetic endowment; health services; and culture.
Income Inequality as a Determinant of Health.
This online resource is a summary based on papers and presentations by a government of
Canada senior policy analyst, and a Quebec director of public health and social services. It
explores the link between socioeconomic status and health outcomes, emphasizing the
abundance of evidence and epidemiological literature confirming that socioeconomic status and
income equality are fundamental determinants of health.
Mikkonen, Juha, and Dennis Raphael. Social Determinants of Health: The Canadian Facts.
Toronto: York University, School of Health Policy and Management, 2010.
This publication by the York University School of Health Policy and Management provides an
introduction to the Canadian social determinants of health, explaining how social factors and
living conditions have been proven to either promote health or cause disease. For each of
fourteen key determinants of health, the authors describe: why the determinant is important to
health; how Canada compares to other wealthy developed nations; and how the quality of the
social determinant can be improved.
The key determinants of health identified, in alphabetical order, are: Aboriginal status, disability,
early life, education, employment and working conditions, food insecurity, health services,
gender, housing, income and income distribution, race, social exclusion, social safety net,
unemployment and job security.
Frohlich, Norman, and Cam Mustard. “A Regional Comparison of Socioeconomic and
Health Indices in a Canadian Province.” Social Science and Medicine 42, no. 9 (1996):
1273-1281.
This study, conducted In 1996, examined correlations between socioeconomic status and health
outcomes. Health (hospital admissions and morbidity) and socioeconomic data were collected at
the enumeration area level, and aggregated at the municipal level. All data were normalized at
the provincial level for purposed of comparison. Correlations were identified between health and
socioeconomic measures using linear regression; regression coefficients were used as weights
in the socioeconomic index. The model was tested for robustness by choosing different levels of
aggregation, excluding portions of the study area, excluding certain indicators, and correlating
individual indicators. The model performed extremely well, yielding consistent results in all
cases.
This study found that socioeconomic risk explains 60% of variance in health status index at the
municipal level, and 87% of the variance at the regional level. It explains over 90% of variance in
both premature death and health care utilization at the regional level. The authors note that the
relationship between socioeconomic status and health occurs as a gradient across the social
hierarchy, rather than at a threshold of absolute poverty. They also theorize that high densities in
a geographic area of individual experiences that contribute to deprivation and therefore poor
health may also have group-level effects. The study does not examine implications for practices
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