The roots of pervasive and damaging health inequities lie deep in fundamental structures of social inequality and exclusion such as income inequality, racism, precarious work, poor housing and homelessness, and inadequate access to health and social services. These social determinants are incredibly complex and dynamic, and policy directions have to be comprehensive and coordinated to address the many inter-dependent and constantly changing forces that shape health.
Wellesley Institute has worked with community and government partners on comprehensive community initiatives and new ways of developing and implementing policy. One approach being explored by the Ontario government is the idea of health in all policies. This involves considering the implications of policy decisions made in departments and programs across government for population health and developing coordinating forums and processes to address the inter-connected nature of the determinants of health.
A crucial variant is not just to understand the overall health implications of policies, but to drill down to analyze the inequitable impact on health of so many policies. For example, fiscal or labour market policy that increase income inequality worsens health inequalities as well. I recently spoke at a workshop on climate change adaptation and health equity sponsored by the Clean Air Partnership and Toronto Public Health. The premise of the conference was that climate change will have adverse health impacts, and these impacts will be worse for disadvantaged populations who have fewer resources to be able to deal with the consequences. Equity-focused planning can help inform climate change adaptation policy.