Social Determinants of Health
Access to conditions that permit health is shaped by the circumstances in which people are born, grow up, live, work and age, and an array of political, economic, social, cultural and environmental conditions and forces. Health inequities are a direct reflection of social inequalities, which means that chances for better health and a longer life increase along the socio-economic gradient. Creating Vibrant Communities recommends public policies that improve the conditions of daily life, tackle the inequitable distribution of power and resources, take action on the social determinants of health and, ultimately, improve health outcomes.
Creating Vibrant Communities is guided by the vision of a poverty-free province where every person has the opportunity to live in dignity and achieve his or her full potential. Breaking the Cycle – Ontario’s Poverty Reduction Strategy, released by the government in December 2008, was a strong start, but poverty remains a distressingly large and increasingly acute problem as
the effects of the recession continue to be felt by the thousands who lost their jobs and who have yet to benefit from any economic recovery.
Poverty is not random. Those most vulnerable to persistent low income include single parents (most frequently mothers), individuals aged 45-64 years and living alone, recent immigrants, persons with a work-limiting disability, Aboriginal people, individuals who drop out of high school, women, and racialized group members. For example, the poverty rate for the racialized family population in Toronto increased steadily from 20.4 per cent in 1981 to 25.5 per cent in 1991, and jumped to 29.5 per cent in 2001. This compares with the 11.6 per cent poverty rate in 2001 for the non-racialized family population. Similarly, in 2000, 37.3 per cent of First Nation individuals were living in poverty compared to 12.4 per cent for non-Aboriginal Canadians.
Overwhelming evidence from academic research and RNs’ own nursing practice shows that differences in social and economic status are directly linked to inequitable health outcomes. As is most evident in a recession, as the income gap between rich and poor widens the health disparities also increase. Those with the lowest income die earlier and have significantly higher incidences of a variety of chronic diseases, conditions and disorders. With the public and private costs of poverty estimated at $32.2 to $38.3 billion, it is clear that social investment to eliminate poverty is good health policy, good social policy and good economic policy.