The Senate Subcommittee on Population Health has been analyzing the social determinants of health and the foundations of health inequalities for several years. Its final report A Healthy Productive Canada: a Determinant of Health Approach has just been released.
The report highlights how broader social and economic determinants of health underlie persistent and shocking health disparities and calls on the federal government to show leadership in addressing these foundations of health inequalities. The report sets out a series of detailed recommendations for the federal government to incorporate a population health policy, including establishing a Cabinet Committee on Population Health; enhanced collaboration and coordination within governments, and cross-government cooperation; use of techniques such as health impact assessments within governments to ensure health is considered in all policies; better health information, equity-relevant statistics and indicators, and sharing research; encouraging multi-year and streamlined funding processes to support community-based service delivery and innovation; governments and the non-profit sector coordinating community level services within a determinants of health approach; and working with Aboriginal peoples to develop a comprehensive strategy to address Aboriginal health disparities.
The report could have focussed more on the underlying roots of social and economic inequality in the current economic system and the long-standing impact of government cuts to social safety funding and programmes in making inequality worse. But it highlights the scale and damage of health inequalities and points the way for concerted federal and other government action.
The report also has two very useful comprehensive reports as appendices. A Life Course Approach to the Social Determinants of Health for Aboriginal Peoples by Jeff Reading, Director of the Centre for Aboriginal Health Research at the University of Regina, sets out a comprehensive analysis of the bases of the terrible disparities faced by Aboriginal peoples in poverty, inequality and the historical and contemporary effects of colonialization, and sets out an action plan including enhanced integration of the myriad of programs and services, creating a strategic alliance to connect up action on the key determinants and Aboriginal led regional health authorities. Act Locally: Community-based population health promotion by long-time expert Trevor Hancock surveys the tremendous potential of community-based health promotion initiatives and identifies the kinds of community-capacity building, integrated service delivery models, and policy frameworks needed to realize that potential in addressing health disparities on the ground.
Wellesley and partners the Canadian Council on Social Development and Health Nexus were on a panel before the Subcommittee on community-based actions to address health inequalities .
We emphasized many of the issues taken up in the final report of concerted and integrated federal and provincial policy commitments; better policy frameworks and coordination; more effective and sustainable funding and support to the community sector; and the need to support community-based innovation. Senate committees have occasionally played a key role in galvanizing policy action around pressing issues. Let’s hope that this is the case here.