Social Determinants of Health

1. Social Determinants of Health Gero 302 Jan 2012

2. SDOH • There are nine SDOH as follows: • Income inequality-The failure to reduce poverty levels to 1989 level shows a trend to increasing income inequality. The poverty gap (gap between the poverty line and average income of poor families or persons below the line increased over the last decade). Incomes have become polarized and there is increasing economic disparity in after tax income. • Social Inclusion and exclusion-impact highest on aboriginal people and immigrants other than from Europe. Visible minority immigrants are at high risk for persistent poverty. Social exclusion is made worse by gender, age, ability, sexual orientation, race, ethnicity, and religion.

3. SDOH • Employment and Job Security-We are now experiencing workforce rationalizations, layoffs, new styles of work, increases in temporary, part time, casual, contract and self-employment. Only one half of all working Canadians has a single full time job that lasts 6 months or more. Only one in two is eligible for EI benefits due to the changes in the styles of work. Less than half of non-unionized workers have access to employer sponsored benefits and pensions. Half working Canadians are experiencing income and job insecurity and are often young parents. This has resulted in more workplace stress and related health problems linked to long working hours, job insecurity, injuries, strain, work and family balance

4. SDOH • Education and Care in Early Life-65-85% of mothers are in the labor force there are only regulated child care spaces for 12% of children. Total spending on Early Education and Care has dropped in recent years in all Provinces except Quebec. Public Schools are under cut-backs, and labour conflict, increased needs for special education and language and cultural diversity. This endangers the health of Canadians and their well-being and social structure. Aboriginal rates of high school graduation is well below average. Children of low income families often exhibit developmental delays and delinquent behaviors and socioeconomic statues exacerbates these problems.

5. SDOH • Housing and Food Security-By 1990 most Province stopped providing social housing, and reduced social assistance rates. This has led to a housing crisis, growing ghettoization particularly among aboriginal, new immigrants and single parent families. Homeowner wealth has increased 29 times greater than renters in 1984 and 70 times in 1999. Rents are taking up 30-50% or more of income leaving little left for food, recreation, transportation and other necessities. • Food insecurity-in 1999 affected 10% of the population representing 3 million people and 678,000 children. Prevalence was highest among lone mothers with children.

6. Taking Action • The broader context-a decline in the Welfare State supporting progressive tax structure and social employment programs to protect families and people who need assistance. The rise of transnational corporations that pressure businesses to reduce costs and maximize profits at the expense of workers. The decline of government structures that mitigate against social exclusion and conflict between business and labor. The recessions of the 80’s and 90’s. Systematic budget cuts in health, social and education sectors. The growth of market driven economic policies with little room for social protection. • Countries such as Finland and Sweden have maintained SDOH policies and programs while enjoying economic growth

7. Key Strategies • Adopt a framework for social inclusion to reduce inequalities related to income, race, gender and ethnicity, geographic location, age, ability, and sexual orientation • Promote full employment and job security. Improve healthy working conditions • Protect universal access to high quality health care that addresses all forms of health with strong infrastructures and funding for health promotion and health protection • Protect and maintain a high quality public education system. Expand early childhood education and care and increase opportunities for lifelong learning and employment training.

8. Strategies • Uphold the right for all Canadians to adequate housing and food. • Reduce income disparity by minimum wages and levels of Social Assistance that allow access to basic necessities. Create a level playing field for tax transfers for both individuals and families and enhance the tax transfers to sustain social, labor and education policies