Social Determinants of Health in Ontario and Canada


How Do Social Determinants Impact Health in Ontario and Canada? 

Canadian Social Determinants of Health 

The Government of Canada defines the determinants of health (DOH) as “the broad range of personal, social, economic, and environmental factors that determine individual and population health.” The main determinants of health include: 

  • Income and social status 

  • Employment and working conditions 

  • Education and literacy 

  • Childhood experiences 

  • Physical environments 

  • Social supports and coping skills 

  • Healthy behaviors 

  • Access to health services 

  • Biology and genetic endowment 

  • Gender 

  • Culture 

  • Race / Racism 

Ontario’s Perspective 

In Ontario, the framework for understanding social determinants of health aligns closely with the World Health Organization's (WHO) definition and serves as a guiding principle for the healthcare system. A key focus within this framework is fostering partnerships between hospitals and communities to improve health outcomes. 

One example of this approach in action within my region is the Community Wellness Hub. The hub's goal is to help seniors live independently in their homes for as long as possible. Services offered include: 

  • One-on-one support to connect individuals with local health and wellness services 

  • A community connector to help coordinate care 

  • Social events, exercise classes, and recreational activities to stay active and form social connections 

  • Workshops on healthy living, mental health, and managing medications 

  • Tablet devices and internet access to help seniors stay connected with loved ones 

The services provided by this Ontario Health Team (OHT) hub have led to a 14% reduction in emergency department visits. This highlights the positive impact of reducing acute service needs for seniors and reallocating resources to support aging at home. The OHT also reports: 

  • Lower hospitalization rates for Ambulatory Care Sensitive Conditions (ACSCs) such as asthma, diabetes, chronic obstructive pulmonary disease, heart failure, hypertension, angina, and epilepsy 

  • Shorter lengths of stay for patients who are hospitalized 

These outcomes demonstrate the effectiveness of integrated care in addressing health needs proactively. By improving access to care within the social determinants of health framework, acute care resources can be significantly reduced. 

The LEGO program, which appears to be a rebranding of the VON initiatives from years past, reflects a time when community care services were more prevalent and accessible in the area, particularly during the 1990s. 

Social Determinants and Cancer Care in Ontario 

A study conducted in Ontario examined the impact of social determinants of health (SDH) on endometrial cancer outcomes. The study included 20,288 participants diagnosed with neoplasms unrelated to behavioral factors. The results revealed an increased mortality rate among marginalized women, particularly those who were diagnosed at an early stage. Marginalization was most prevalent among women over the age of 70, living in urban areas, with lower income, and suffering from severe obesity (Anderson et al., 2022). 

This study provides evidence that social determinants of health significantly affect cancer care outcomes. It underscores the need to further explore these correlations and develop strategies to address the disparities that exist within the healthcare system. 

 References 

 

Helpman, L., Pond, G.R., Elit, L., Anderson, L.M., Kong, I., Schnarr, K., Seow, H., (2022) Disparities in the survival of endometrial cancer patients in a public healthcare system: A population-based cohort study. Gynecologic Oncology 167, 532-539. https://doi.org/10.1016/j.ygyno.2022.09.015


Government of Canada (2024)

What-determines-health.html 

 

Ontario Health (2024) 

Social-Determinants-of-Health–FNIMui-Resource-Guide.pdf 

Community-wellness-hub 

SocialDeterminantsOfHealth-Framework-EN.pdf

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