Introduction
Health is a basic secondary unit essential in an individual’s life. Social determinants of health significantly impact an individual’s health status. These include education, income, food security, employment, social exclusion, etc. In various countries, government officials have set up public policies. These have a significant impact on the social determinants of health. Canada is a developed country that considers health an essential aspect of the citizens. In Canada, it has been noted that the social determinants of health are highly affected by public policies. These include food security, housing, and early childhood development. The paper will discuss why it is difficult for Canada, a liberal welfare State, to address the social determinants of health and how citizens could create a positive change.
Relationship between Health Social Determinants and Public Governmental Policies
Early childhood development is children’s emotional, social, cognitive, and physical development from birth to age eight. It is a critical time for brain development, and experiences are used to shape children’s future in health and education. It is a crucial determinant of children’s health and later in their adulthood. According to Hertzman’s approach to ECD, physical development helps in body growth and the development of various skills, such as walking and running (Raphael, 2016). Emotional development allows children to express emotions appropriately and build a relationship with others. In cognitive development, children develop reasoning skills and solve problems. Positive nurturing experiences during early childhood allow children to develop healthy brains and emotional well-being. It plays a crucial role in an individual’s future health and well-being. Children who grow up in poverty will likely develop various mental health issues and chronic diseases. For instance, in various countries, governments have set up programs that ensure children from low-income families can access food. They have allowed families who have children to get financial assistance. For instance, in Canada, the country has the Canada Child Benefit, a tax-free monthly payment to eligible families to help with the cost of bringing up children under the age of 18 years (Canada, 2022). It helps with child care, education, and nutritious food costs. It has been shown to have a positive impact on child development. For example, increased health outcomes for children and school readiness have been reported. In addition, parental mental health has also improved (Pentland, Cohen, Guttmann, & Oliveira, 2021).
Housing is a fundamental health determinant since it is essential in providing a safe environment for families and individuals. For people to maintain good health, they need to have access to affordable and safe housing. People need to stop living in damp and low-quality housing. Canadian studies confirm that people living in poor housing will likely take up behaviors such as excessive alcohol consumption. In Canada, one in five households needs help to afford healthy homes. It has been estimated that at least 200,000 candidates sleep outside or access homeless emergency services in a year. The root cause of the numbers is that the government cut provincial and federal funding and programs for new social housing over 20 years (Raphael, 2016). Most Canadian residents have been forced into a bleak rental market that cannot keep up with the rising demand. The Canadian government previously had a national housing program that funded housing units. They abandoned housing policies as time passed, hoping the private markets would fill the gap.
The low income most Canadian citizens earn has made a living in cities difficult. According to the UN, people in Canada are homeless, and a high percentage live in shelters while others die due to the nationwide housing Crisis. As a result of poor housing conditions, most tenants in Canada pay almost 50% of their gross income to their tenants. These conditions have affected their health, especially stress and mental insecurity of lacking money to pay rent (Raphael, 2016). In the UK, homeless people experience poorer health outcomes than the larger population. They are likely to have respiratory diseases and mental health issues, prone to violence, suicide, and drug dependence. A Toronto survey of homeless people found much higher risks than the general population.
Most government authorities have ensured that there is a provision of affordable housing policies to ensure that citizens have access to stable and safe housing. In Canada, the National Housing Strategy has provided funding for renovating and constructing affordable housing units (Raphael, 2016). Canada hopes to invest over 82 billion dollars in the National Housing Strategy to ensure Canadians have access to affordable housing, hence building stronger communities. In addition, some governments have set up housing quality standards to ensure tenants have access to quality houses that will protect their health. For instance, the provision of well-ventilated, constructed, and designed houses.
Food insecurity is inadequate access to food due to financial constraints. In high-income countries such as Canada, it is easier to assume that hunger and access to food are not problems that occur in the population. Food security has been a significant element in maintaining a healthy and active life among various individuals. Globalized food systems, international trade of food commodities, agricultural policies that affect local domestic producers, and processed food marketing and distribution are among the conditions that lead to household insecurity (Raphael, 2016). One out of three households in Canada has consistently complained of food insecurity in Northern Aboriginal populations. They lack access to affordable fruits, vegetables, and meat due to the high transportation costs. In health, there are several instances when individuals have been diagnosed with poor nutrition. For instance, on several occasions, children have been diagnosed with kwashiorkor, rickets, and low weight. Individuals who experience food insecurity are highly prone to various health conditions since it is a basic need that helps the body to fight against diseases. During the COVID-19 pandemic, many individuals were suffering from food insecurity globally.
In various countries, governments have implemented policies that improve food security. For example, in Canada, the government has implemented the Canada Emergency Response Benefit (CERB) to provide financial assistance to individuals who lost their jobs during the pandemic. This helped in alleviating food insecurity conditions among the populations. Governments have set up various dietary guidelines to educate citizens on diets that are important for them. In addition, the Canada Food Guide, a set of dietary guidelines, has been implemented to help citizens have the best recommendations on healthy eating.
Correlation between Income and the Onset Heart Disease and Type 2 Diabetes
Heart disease is various condition that affects the heart. It could be coronary artery disease, irregular heartbeats, heart valve disease, or heart muscle disease. Healthy lifestyle choices can prevent or treat many forms of heart disease. Type 2 diabetes is when the body cannot properly regulate and use sugar or glucose. High blood sugar leads to immune, nervous, and circulatory system disorders. The disease is more common in adults. It can also affect obese children. There is no cure for Type 2 Diabetes. However, weight loss, eating well, and exercising regularly can help manage the disease.
According to Bird et al. (2015), a study in Canada confirms a high correlation between the onset of heart disease and Type 2 Diabetes (Bird, Lemstra, Rogers, & Moraros, 2015). In addition, the authors argue that it is a misconception to conclude that diseases are only meant for the wealthy. The study outlined that low income increased the risk of developing diabetes. Among 98,298 Canadians, the lower income males are 94% likely to have Type 2 Diabetes, while 175% lower income females are likely to have diabetes (Williams, 2018). Moreover, among lower-income and higher-income individuals, the prevalence of Type 2 Diabetes is 9.1% and 2.2%, respectively (Placeholder 4).
First, lack of physical activity is one of the causes of the disease. Low-income people have limited access to opportunities for physical activity, healthy foods, and safe neighborhoods to walk around. Poverty makes them more likely to be stressed out and engage in unhealthy smoking behaviors. Low-income forces individuals to develop chronic stress that leads to diseases such as Type 2 Diabetes (Raphael, 2016). Secondly, low-income people are more likely to be exposed to polluted environments that could lead to heart conditions and Type 2 Diabetes. Lastly, low-income people may have limited access to healthcare, leading to treatment delays, which could later develop into Type 2 Diabetes and Heart Disease. Poor management of the diseases could risk these conditions. People with high income may engage in unhealthy lifestyles like fatty foods that could lead to the development of the two diseases.
Why Addressing Social Determinants of Health is Difficult in Canada
A liberal welfare state is a governing structure that ensures citizens are cared for economically and socially. Its main aim is to ensure that citizens receive all their basic needs equally with little government interference. Canada is a liberal State that gives citizens access to publicly funded social services, healthcare, and income security programs (Raphael & Bryant, 2022). However, it has some features that have made it difficult to address social determinants of health. First, limited funding for social programs makes it difficult to access housing and food security. For instance, after the high reliance on private housing, the country increased the chances of living on the streets. Most individuals are struggling with their health because they do not have access to safe and secure environments in Canada. For instance, most people suffer from heart disease because they live in poorly ventilated-houses. However, in other social democratic welfare states, it has been easier to address housing as a social health determinant since adequate funding ensures that individuals live in well-ventilated and secure households.
Secondly, Canada has a complex governmental structure with responsibility shared between territorial, provincial, and federal governments. The complexity has made it difficult to set up strategies to address the social determinants of health (Raphael, 2016). In most cases, the approaches have gaps that do not address the root cause of the problems. The social services in the country need to be more cohesive, making the system more complicated and confusing. However, in a country such as Denmark and Norway, the governmental structure is centralized, which has made it easier to address health. For instance, it is much easier to set up policies and ensure that the root cause of the problems has been handled.
Third, in Canada, the government has highly emphasized individual responsibility. Individuals are expected to take care of their health. This means that individuals do what can favor them and may not consider others who may be suffering than them. The implementation of social health determinants needs to be improved since individuals highly rely on ideological beliefs and how they benefit through them. In addition, individuals believe their social class income, power, and wealth are through their efforts. In Canada, power and influence dictate the quality distribution of social determinants of health, making it hard to implement policies that offer standard health care. According to Raphael (2016), Canada has a high reliance on individualism that limits movements for social activism. It is challenging to spur change in a country where public issues are private matters of assertiveness, lifestyle, and self-empowerment. Discrimination against indigenous people is high, making it difficult for them to access equal health. A study shows higher rates of chronic diseases and mental issues among them (Raphael, 2016). Social equality means everyone has access to social services regardless of their social class. This has improved health outcomes and decreased the impact of social determinants of health. In countries such as Norway, the country has embraced the importance of social equity, making it easier to decrease the social health determinants. In addition, Canada could emulate models of social democratic and conservative welfare states. Lastly, Canada is a country that highly relies on profit from business and corporate sectors. A reduction of taxes and minimum wages or a drive for more profit has highly affected people’s welfare and directly impacted social determinants of health.
Role of Citizens in Addressing Social Determinants of Health in Canada
Canadian citizens help ensure that addressing social determinants of health is more effortless. First, they could advocate for policies that address the social determinants of health. They could write to their elected officials and express their concerns about the importance of health to the economy of Canada (Raphael, 2016). This creates attention to citizens’ issues, hence the pressure on higher officials for a policy change. In addition, the officials could feel the urge from the citizens if they can feel how they feel and understand their thoughts. If a citizen speaks of a lack of funds in housing programs, the officials could consider this by including more funds to ensure that every member of the disadvantaged population receives funds. Additionally, they could participate in public consultations that allow them to share their ideas about the policies that have been set up and how they affect their health access. Citizens could join Unions and bargain collectively for equal and quality distribution of social health determinants.
Volunteering has been one of the best ways of addressing health. Young citizens could help by volunteering at community organizations and raising awareness about issues affecting health’s social determinants. For health equity issues, especially for indigenous members of the population, they could volunteer to raise awareness of the importance of health equity and social justice. In addition, citizens could ensure they participate in election processes. An election process helps members ensure they have elected officials they think will address their social issues (Raphael, 2016). Therefore, if Canadian citizens elect candidates, they will consider the social issues they face; they will help address the social determinants of health. Lastly, citizens must educate themselves about health’s social determinants and how they impact health outcomes. They could educate themselves and others on potential ways in which policy change could be advocated for.
Reflection and Conclusion.
In conclusion, from this course, I have learned that the York University conference listed various social determinants of health in Canada. These living and working conditions affect both developed and developing countries. These include; early child development, employment and working conditions, food security, education, housing, social exclusion, and many more. Government policies are directly related to these social determinants of health. Therefore, any government’s policy significantly impacts health and social determinants. Social determinants are overlooked in shaping health outcomes, especially in most developing countries (Raphael, 2016). Policies are highly dictated by corporate and business tycoons leading to unequal distribution of social health determinants. They do not exist in a vacuum since public policy environments play a huge role in shaping them. Politics and political ideology indirectly affect social determinants of health, especially in food security, where prices are highly affected by globalized food systems, international trade of food commodities, agricultural policies that affect local domestic producers, and processed food marketing and distribution.
There is a possible change of attitude, especially after watching the video “Unnatural causes: is inequality making us sick.” I realized that even are not only high-income individuals highly exposed to heart disease and type 2 diabetes but also low-income individuals at a higher percentage. High-income individuals are assumed to be prone to these diseases due to their lifestyle choices. However, I noted that low-income individuals are highly exposed due to insufficient funds to ensure a comfortable and healthy lifestyle. For instance, high-income individuals can access immediate healthcare and maintain a healthy lifestyle by exercising in fitness centers. This reduces their chances of becoming sick compared to the low-income individuals who could develop mental stress conditions because they cannot raise funds to seek immediate treatment or eat balanced diets.
Similarly, I have also learned that individual health outcomes are not only determined by personal choices or genetics but by the economic, social, and environmental conditions we live in. To address health as a problem, it is essential to consider the leading causes of health inequities and social determinants. In addition, citizens have a massive role in addressing the social determinants of health. They could do this by educating, advocating, and voting for suitable candidates. The leading killer of people is not inequalities but rather the individuals who are in charge of inequalities and become dormant in taking a step to ensure equality is promoted in health.
In addition, Canada has highly relied on private housing, affecting many households with poor access to housing. In the past, the Canadian government had a public program that ensured all Canadian citizens had access to affordable housing. However, the programs were erased with time, and the government allowed the private sector to ensure citizens had access to housing. The government has seen that many individuals need better access to housing, which has increased compared to the past years. Those in the business and corporate sectors are part of the government authorities and policymaking since the public policies are twisted to favor them. Canada is a capitalist society that controls and influences government policies. For instance, trade unions are not representative of the workers.
References
Bird, Y., Lemstra, M., Rogers, M., & Moraros, J. (2015). The relationship between socioeconomic status/income and prevalence of diabetes and associated conditions: A cross-sectional population-based study in Saskatchewan, Canada. 14, 93. doi:10.1186/s12939-015-0237-0
Canada. (2022, December 12). Tax credits and benefits for individuals. Retrieved from https://www.canada.ca/en/services/taxes/child-and-family-benefits.html
Pentland, M., Cohen, E., Guttmann, A., & Oliveira, C. d. (2021). Maximizing the impact of the Canada Child Benefit: Implications for clinicians and researchers. Paediatrics & Child Health, 26(4), 214-217. doi: 10.1093/pch/pxaa092
Raphael, D. (2016). Social determinants of health: Key issues and themes.
Raphael, D., & Bryant, T. (2022). Emerging Themes in Social Determinants of Health Theory and Research. 52(4), 428–432. doi:10.1177/00207314221109515
Williams, D. (2018, February 6). Unnatural Causes: Is Inequality Making Us Sick? Retrieved from https://www.youtube.com/watch?v=aTIPBQMpF9Y
write