The determinants of health can be defined as a broad range of social, economic, personal and environmental factors that help determine the health of individuals and populations (Government of Canada, 2018). It involves the conditions in which individuals are born, live, grow, work and age (Canadian Nurses Association, 2013). The health determinants that define individual and population health are income and social status, employment and working conditions, education and literacy, childhood experiences, physical environments, social supports and copying skills, healthy behaviours, access to health services, biology and genetic endowment, gender and culture (Government of Canada, 2018). In Ontario, the main determinants of health are identified as education, employment, income, immigration and Aboriginal population (Public Health Ontario, 2015). The demographic differences in the Ontario population plays a vital role in determining the health status of the population as a whole (Public Health Ontario, 2015).
On the other hand, the social determinants of health are described as a more specific cluster of social and economic factors within the broad definition of the determinants of health (Government of Canada, 2018). The social determinants of health relate to factors such as early childhood and access to education, access to healthy food and adequate income, nature of employment and working conditions, social inclusion, access and use of health care, access to housing, and the quality of built and natural environment in which people live (Canadian Nurses Association, 2013).The social determinants of health are viewed as the main cause of health inequities. Health inequities are unfair or unjust systems and policies that cause differences in the health status of individuals and groups (Government of Canada, 2018). According to Health Nexus (2018), the social determinants of health affect everyone, not just those that experience limited or poor access involving the determinants of health. In order to address the inequities involving the social determinants of health, the primary focus should not be placed in providing health care, but instead on other factors such as adequate income and housing, food security, social inclusion and early childhood development, among other social determinants (Canadian Nurses Association, 2013).
The World Health Organization identified three key principles in eliminating health inequities. These principles include improving the conditions of daily life for individuals, fixing the problem of unfair distribution of power, money and resources globally, nationally and locally, and developing a workforce that is trained in raising public awareness of the social determinants of health (Canadian Nurses Association, 2013). In addition, addressing health policies that impact access to health services helps promote health equity. Unlike the determinants of health, the social determinants are modifiable by way of creating and investing in policies that promote improvements in health for the most marginalized in society (Health Nexus, 2018). The Canadian Nurses Association (2013) identified the “Health in all policies” concept that assesses how health impacts policies in areas such as education, housing, finances, employment and transport. It prompts leaders and policy makers to integrate health, equity and well-being when developing, implementing and evaluating polices and services (Canadian Nurses Association, 2013).
As healthcare providers, nurses can take on an active role in promoting health equity, not just on the individual but also at the structural level. As nurses, we need to individually and collectively advocate towards the eliminations of social inequities as much as possible (Canadian Nurses Association, 2013). Nurses can advocate for health equity and social justice in resource allocation, access to health care, and various social and economic services (Canadian Nurses Association, 2013).
References
Canadian Nurses Association (CNA). (2013). Position Statement – Social Determinants of Health. Retrieved from https://www.cna-aiic.ca/~/media/cna/files/en/ps124_social_determinants_of_health_e.pdf
Government of Canada. (2018). Social determinants of health and health inequalities. Retrieved from https://www.canada.ca/en/public-health/services/health-promotion/population-health/what-determines-health.html
Health Nexus. (2018). Social Determinants of Health: Planning to Action. Retrieved from http://www.ohpe.ca/node/13374
Public Health Ontario. (2015). Ontario’s Population – Determinants of Health. Retrieved from https://www.publichealthontario.ca/en/eRepository/OHP_infog_Population_2014.pdf