Integrating Social Determinants of Health and Health Equity into Canadian Public Health Practice:
Environmental Scan 2010
National Collaborating Centre for Determinants of Health (NCCDH)
Available online PDF [90p.] at: http://bit.ly/gboXhJ
“…..environmental scan to inform its future direction, priorities and activities through an analysis of the key challenges, needs, gaps, and opportunities in the determinants of health for public health.
A four-member expert reference group was established to provide strategic input into the conduct of the scan.
This environmental scan utilized four information gathering approaches:
- a focussed scan of the literature;
- 31 key informant interviews with practice and research experts;
- four focus group teleconferences to validate early emerging themes; and,
- an online survey with over 600 respondents.
There was considerable convergence of the findings across the four information gathering approaches.
Despite public health’s more distant and recent history, public health action on broader health determinants is not widespread and may even be viewed as ‘new’. Either the application of foundational concepts was never universally institutionalized throughout public health or enough time has passed and pressures exerted upon the public health sector that they have been lost. Even within early adopter organizations, action on determinants of health is still at a relatively early stage of implementation versus having been institutionalized throughout. …”
“…..A number of pervasive challenges are barriers to more widespread action. These include: the lack of clarity regarding what public health should or could do; a limited evidence base; preoccupation with behaviour and lifestyle approaches; bureaucratic organizational characteristics; limitations in organizational capacity; the need for leadership; more effective communication; and supportive political environments.
Overall, there appear to be four key roles for public health action on health determinants to reduce health inequities:
· Assess and report on the health of populations describing the existence and impact of health inequalities and inequities and, effective strategies to address those inequalities/inequities.
· Modify/orient public health interventions to reduce inequities including the consideration of the unique needs and capacities of priority populations (i.e., do planning and implementation of existing programs considering inequities).
· Engage in community and multi-sectoral collaboration in addressing the health needs of these populations through services and programs (i.e., when looking at the collectivity of our programming for ‘x’, where are the gaps?).
· Lead/participate and support other stakeholders in policy analysis, development and advocacy for improvements in health determinant/inequities…”
Content:
Executive Summary
1. Introduction .
2. Methodology
3. Findings
Context for Public Health Action on the Determinants of Health
Key Concepts and Terminology
Public Health’s Roots and History .
Recent Major Reports Addressing Health Determinants and Equity – Selected Examples .
Formal Expectations for Public Health Action on Health Determinants and Health Inequalities/Inequities .
State of
Challenges to Public Health Action
Opportunities (Reasons for Optimism)
4. Analysis and Implications for Future NCCDH Actions
5. Conclusion and Next Steps
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