Canadian Contributions
Canadians have also been active in theorizing the relationship
between conditions of everyday life and health. In 1974 the federal
government's report, A New Perspective on the Health of Canadians (the
Lalonde report), saw health and illness as being determined by human
biology, environment, lifestyle, and health care organization. The document
was important in that it identified determinants of health other than the
health care system.
Another Canadian government document was Achieving Health for All: A
Framework for Health Promotion (the Epp report, 1986). It identified that
the prime goal of reducing inequities between income groups could be
accomplished by influencing policies that have a direct bearing on health:
The list of policy areas is long and includes, among others, income
security, employment, education, housing, business, agriculture,
transportation, justice and technology. The Health Canada document, Taking
Action on Population Health: A Position Paper For Health Promotion and
Programs Branch Staff (1999), states
There is strong evidence indicating that factors outside the health
care system significantly affect health. These "determinants of
health" include income and social status, social support networks,
education, employment and working conditions, physical environments,
social environments, biology and genetic endowment, personal health
practices and coping skills, healthy child development, health
services, gender and culture.
Canadian Public Health Association (CPHA) documents tell a similar
story. In 1986, its Action Statement for Health Promotion in Canada
identified advocating for healthy public policies as the single best
strategy to affect the determinants of health. Priority areas mentioned
include reducing inequalities in income and wealth, and strengthening
communities through local alliances to change unhealthy living conditions.
In 2000, the CPHA endorsed an action plan that recognized the profound
influence of poverty on health and identified ways to reduce its incidence.
Other CPHA reports document the health effects of unemployment, income
insecurity, and homelessness.
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