Book Review
Social Determinants of Health: Canadian Perspectives
Dennis Raphael (ed.)
Canadian Scholars' Press Inc., Toronto, 2004
448 pages, $39.95
Professor Dr. Benita Cohen, University of Manitoba
Canadian Journal of Public Health, 2005, vol. 96, no. 5, p. 397.
This book makes a highly significant contribution to the field of Public
Health in Canada. Edited by Dr. Dennis Raphael at York University's School
of Health Policy and Management in Toronto, it presents the findings of a
conference entitled Social Determinants of Health Across the Life-Span,
which took place in Toronto in 2002. The immediate outcome of the
conference was the drafting by participants of The Toronto Charter for A
Healthy Canada (presented in an appendix), which identified key social
determinants of health (SDOH) especially relevant to Canadians. This
volume explores the state of each of these determinants and implications of
these conditions for Canadians' health. It is organized into five
sections: income security and employment; education; food and shelter;
social exclusion; and social policy.
Aside from being well-researched and well-written, a major strength of the
book is its focus on identifying clear policy directions to improve the
health of Canadians by influencing each of the social determinants.
Raphael & Curry-Steven's concluding chapter on surmounting the political
and social barriers to health is particularly noteworthy. Another
highlight is the inclusion of thought-provoking critical analyses of the
social economy approach in addressing the SDOH (Chapter 22) and the concept
of social inclusion/exclusion (Chapter 17). An annotated list of
recommended readings and relevant web sites at the end of every chapter is
a very useful feature. There is occasionally some overlap in the
discussion in separate chapters exploring different aspects of the same
social determinant, but this does not detract from the overall strength of
the volume, and it could even be viewed as useful for those individuals who
don't have time to read every chapter.
Raphael's book is essential reading for university students, practitioners,
program managers and policymakers in all of the human service sectors. It
is especially relevant to individuals in the Public Health sector. Among
many important messages that Public Health needs to pay attention to are
the need for social determinants to have a much higher priority on the
health policy and action agenda in Canada than they do now, and the need
for the health sector to engage more effectively in inter-sectoral action
to improve the SDOH.
This excellent volume convincingly makes the argument that reducing social
inequities in Canadian society is essential to Canadians' health. The
Public Health sector should be taking a leading role as activists in
pursuing this goal.
Social Determinants of Health: Canadian Perspectives
General Editor, Dennis Raphael, Foreword by Hon. Roy J. Romanow, P.C.,
O.C., Q.C.
http://www.cspi.org/books/s/socialdeter.htm
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