Social determinants of health and health inequalities

Social and economic influences on health

Many factors have an influence on health. In addition to our individual genetics and lifestyle choices, where we are born, grow, live, work and age also have an important influence on our health.

Determinants of health are the broad range of personal, social, economic and environmental factors that determine individual and population health. The main determinants of health include:

Income and social status
Employment and working conditions
Education and literacy
Childhood experiences
Physical environments
Social supports and coping skills
Healthy behaviours
Access to health services
Biology and genetic endowment
Race / Racism

Social determinants of health 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.

Health inequalities in Canada

Canada is one of the healthiest countries in the world.  However, some Canadians are healthier and have more opportunities to lead a healthy life.

Differences in the health status of individuals and groups are called health inequalities. These differences can be due to your genes and the choices you make. For example, whether you exercise or drink alcohol. However, the social determinants of health can also have an important influence on health. For example, Canadians with higher incomes are often healthier than those with lower incomes.

Health inequity refers to health inequalities that are unfair or unjust and modifiable. For example, Canadians who live in remote or northern regions do not have the same access to nutritious foods such as fruits and vegetables as other Canadians.

Health equity is the absence of unfair systems and policies that cause health inequalities. Health equity seeks to reduce inequalities and to increase access to opportunities and conditions conducive to health for all.

Supporting the reduction of health inequalities

Reducing health inequalities means helping to give everyone the same opportunities to be healthy, no matter who they are or where they live.  We are working in a number of ways to reduce health inequalities and address the social determinants of health.

Strengthening the evidence base to inform decision-making

The Health Inequalities Data Tool contains a large set of data on health inequalities in Canada by subgroups of the Canadian population, including by social, economic and demographic factors. For example, the size and impacts of health inequalities are available by Indigenous Peoples, Black Canadians, immigrants or Canadians living in rural/remote or urban settings. It was created by the Public Health Agency of Canada and the Pan-Canadian Public Health Network, in collaboration with 

Statistics Canada, and the Canadian Institute for Health Information.

The Key Health Inequalities in Canada: A National Portrait report discusses important health inequalities in Canada. It was developed by the Public Health Agency of Canada and the Pan-Canadian Public Health Network in collaboration with Statistics Canada, the Canadian Institute for Health Information, and the First Nations Information Governance Centre.
Data on Indigenous children, and health and development in the early years supports the design of effective early childhood development programs and interventions. These resources were developed by the Canadian Institute of Child Health in partnership with the Canadian Council on Social Determinants of Health and the Public Health Agency of Canada.

Engaging beyond the health sector

The Public Health Agency of Canada established the Canadian Council on Social Determinants of Health to work with leaders from different sectors on the social determinants of health and improve health equity. The Council has produced a number of resources and tools, for example:

Roots of Resilience: Overcoming Inequities in Aboriginal Communities
A Review of Frameworks on the Determinants of Health
Pan-Canadian resource on evidence and initiatives to improve the determinants of health for children and their families

Sharing knowledge of action across Canada

Under the Rio Political Declaration on Social Determinants of Health in 2012, Canada and other member states pledged to take steps to improve health equity. We have documented examples of actions across Canada in these areas as part of the following reports:

Rio Political Declaration on Social Determinants of Health: A Snapshot of Canadian Actions 2015
Rio Political Declaration on Social Determinants of Health : A Selection of Canadian Actions 2013

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