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Social determinants of health

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  1. 25 in 5: Breakout Group on Health/Well-Being/Social Inclusion What Kinds of Measures Would Show Progress in Reducing Poverty?Monday, January 28, 2008Lynn Anne MulrooneyRegistered Nurses’ Association of Ontario

  2. early childhood development education employment and working conditions food security health care services housing income and its distribution social exclusion social safety nets Unemployment Women, Aboriginal people, Canadians of colour, and new Canadians—systemic & structural inequalities Toronto Charter for a Healthy Canada Social determinants of health

  3. Why Poverty Matters Life expectancy at birth (2005): Japan 82.3 years Zambia 40.5 years HDR 2007-2008 Early life experiences have a life-long impact on brain and body development. Children living in poverty are at greater risk for poorer mental and physical health throughout life. Keating & Hertzman, 1999

  4. Death and Social Gradient

  5. Unexplained Risk of Social Gradient

  6. Resources: Raphael, Dennis (2007). Poverty and Policy in Canada: Implications for Health and Quality of Life. Toronto: Canadian Scholars’ Press. Marmot, Michael (2004). The Status Syndrome: How Social Standing Affects our Health and Longevity. New York: Henry Holt & Co.

  7. Political Regimes & Health Outcomes: “Health is a measure of the degree to which the society delivers a good life to its citizens.” Sir Michael Marmot, WHO Commission on SDOH Political traditions that were more egalitarian & implemented redistribution policies had less poverty, less income inequality, lower infant mortality, & higher life expectancy. (Navarro & Shi: 2001; Navarro et al. 2006)

  8. Definitions Life expectancy: number of years a person would be expected to live, starting at birth… Infant mortality: incidence of newborns dying during first year of life (per 1,000 live births)

  9. Changes over time

  10. Life expectancy in Canada

  11. Life Expectancy, Males, Canada 1996 Yrs Source: Wilkins et al., 2002, Health Reports

  12. Life Expectancy, Females, Canada, 1996 Yrs Source: Wilkins et al., 2002, Health Reports

  13. Infant Mortality

  14. Infant Mortality, 1996

  15. Questions • Within this sector, what do we want a poverty reduction strategy to change? • How can we measure whether that change is happening?

  16. Questions • How can we ensure that the changes and measures or indicators benefit marginalized groups, specifically: • Racialized groups • Women • Person with disabilities • Aboriginal people • Newcomers • children