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Canada: A land of missed opportunity for addressing the social determinants of health

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  • Bryant, Toba
  • Raphael, Dennis
  • Schrecker, Ted
  • Labonte, Ronald
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    Abstract

    The first 25 years of universal public health insurance in Canada saw major reductions in income-related health inequalities related to conditions most amenable to medical treatment. While equity issues related to health care coverage and access remain important, the social determinants of health (SDH) represent the next frontier for reducing health inequalities, a point reinforced by the work of the World Health Organization's Commission on Social Determinants of Health. In this regard, Canada's recent performance suggests a bleak prognosis. Canada's track record since the 1980s in five respects related to social determinants of health: (a) the overall redistributive impact of tax and transfer policies; (b) reduction of family and child poverty; (c) housing policy; (d) early childhood education and care; and (e) urban/metropolitan health policy have reduced Canada's capacity to reduce existing health inequalities. Reasons for this are explored and means of advancing this agenda are outlined.

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    Bibliographic Info

    Article provided by Elsevier in its journal Health Policy.

    Volume (Year): 101 (2011)
    Issue (Month): 1 (June)
    Pages: 44-58

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    Handle: RePEc:eee:hepoli:v:101:y:2011:i:1:p:44-58

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    Web page: http://www.elsevier.com/locate/healthpol

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    Keywords: Social determinants of health Public policy Canada;

    References

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    1. Navarro, Vicente & Shi, Leiyu, 2001. "The political context of social inequalities and health," Social Science & Medicine, Elsevier, vol. 52(3), pages 481-491, February.
    2. R Evans & G Stoddart, 1990. "Producing Health, Consuming Health Care," Centre for Health Economics and Policy Analysis Working Paper Series 1990-06, Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, Canada.
    3. Hayes, Michael & Ross, Ian E. & Gasher, Mike & Gutstein, Donald & Dunn, James R. & Hackett, Robert A., 2007. "Telling stories: News media, health literacy and public policy in Canada," Social Science & Medicine, Elsevier, vol. 64(9), pages 1842-1852, May.
    4. Raphael, Dennis & Curry-Stevens, Ann & Bryant, Toba, 2008. "Barriers to addressing the social determinants of health: Insights from the Canadian experience," Health Policy, Elsevier, vol. 88(2-3), pages 222-235, December.
    5. Esping-Andersen, Gosta, 1999. "Social Foundations of Postindustrial Economies," OUP Catalogue, Oxford University Press, number 9780198742005, September.
    6. Heisz, Andrew, 2006. "Canada's Global Cities: Socio-economic Conditions in Montreal, Toronto and Vancouver," Trends and Conditions in Census Metropolitan Areas 2006010e, Statistics Canada, Social Analysis and Modelling.
    7. Heisz, Andrew, 2007. "Income Inequality and Redistribution in Canada: 1976 to 2004," Analytical Studies Branch Research Paper Series 2007298e, Statistics Canada, Analytical Studies Branch.
    8. Evans, Robert G. & Stoddart, Gregory L., 1990. "Producing health, consuming health care," Social Science & Medicine, Elsevier, vol. 31(12), pages 1347-1363, January.
    9. Bryant, Toba, 2003. "A critical examination of the hospital restructuring process in Ontario, Canada," Health Policy, Elsevier, vol. 64(2), pages 193-205, May.
    10. Evans, R.G. & Stoddart, G.L., 1990. "Producing Health, Consuming Health Care," Centre for Health Services and Policy Research 90:13r, University of British Columbia - Centre for Health Services and Policy Research..
    11. Siddiqi, Arjumand & Hertzman, Clyde, 2007. "Towards an epidemiological understanding of the effects of long-term institutional changes on population health: A case study of Canada versus the USA," Social Science & Medicine, Elsevier, vol. 64(3), pages 589-603, February.
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