We often speak of patient’s need to advocate for themselves and for their own health and wellness. However, we need to ask ourselves if all Canadians have equal access to health care? At first, we all say yes, the reality is there is a difference. The term used to describe this is health inequalities, which means “differences in the health status of individuals and groups... due to your genes and the choices you make” (Canada, 2021). Mikkonen (2010) has described the health inequalities as social determinants of health (SDH) in the following infographic:
WHO (2021) has listed “examples of the social determinants of health, which can influence health equity in positive and negative ways” and Canada (2021) has identified the following 12 main SDH that align with examples provided by WHO:
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
Gender
Culture
Race / Racism
Understanding that health access is inequitable and that this is impacted by several SDH, the goal of our Canadian and Alberta health care system is to make it equitable. Canada (2021) shares that “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 of need to address equity access “. To make this change, we require a multilevel strategy and engagement from public, health care providers and our government. Let’s look the strategies that have been proposed and implemented by the Canadian Government, the Alberta Government and a viewpoint from healthcare provider.
Upon reflection on the strategies described, it becomes quite clear that we need to change the way we provide health care. We need to ask important questions and flag social determinants of health in patient charts and records. We need to explore program funding options, community programs. outreach options and most importantly removing our personal biases form a system perspective. At the patient level be guidelines, policies, education, monitoring progress and sharing reports with data. Here is a look at the vision of Alberta Health services on creating healthy communities:
The key initiatives that can be read as being priorities for Alberta Health are:
Alberta's COVID-19 Response
Improving Health Care System
Reducing Surgical Wait Times
References
Mikkonen, J., & Raphael, D. (2010). Social Determinants of Health: The Canadian Facts.
Toronto: York University School of Health Policy and Management.
Public Health Agency of Canada, (2021). Government of Canada. Social determinants of health and health inequalities - Canada.ca. https://www.canada.ca/en/public-hea
lth/services/health-promotion/population- health/what-determines-health.html.
World Health Organization. (2021). Social Determinants of Health. World Health Organization. https://www.who.int/westernpacific/health-
topics/social-determinants-of-health.
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