Another edition to the Canadian literature! 

See also:  http://journal.cpha.ca/index.php/cjph
/article/download/1135/1135 (14 years old)



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Integrating Social Determinants of Health and Health Equity into Canadian 
Public Health Practice:
Environmental Scan 2010

National Collaborating Centre for Determinants of Health (NCCDH)
St. Francis Xavier University ? March 2011

Available online PDF [90p.] at: http://bit.ly/gboXhJ 

??..environmental scan to inform its future direction, priorities and 
activities through an analysis of the key challenges, needs, gaps, and 
opportunities in the determinants of health for public health.

A four-member expert reference group was established to provide strategic 
input into the conduct of the scan.

This environmental scan utilized four information gathering approaches: 
- a focussed scan of the literature;
- 31 key informant interviews with practice and research experts; 
- four focus group teleconferences to validate early emerging themes; and, 
 
- an online survey with over 600 respondents. 
There was considerable convergence of the findings across the four 
information gathering approaches.

Despite public health?s more distant and recent history, public health 
action on broader health determinants is not widespread and may even be 
viewed as ?new?. Either the application of foundational concepts was never 
universally institutionalized throughout public health or enough time has 
passed and pressures exerted upon the public health sector that they have 
been lost. Even within early adopter organizations, action on determinants 
of health is still at a relatively early stage of implementation versus 
having been institutionalized throughout. ??

??..A number of pervasive challenges are barriers to more widespread 
action. These include: the lack of clarity regarding what public health 
should or could do; a limited evidence base; preoccupation with behaviour 
and lifestyle approaches; bureaucratic organizational characteristics; 
limitations in organizational capacity; the need for leadership; more 
effective communication; and supportive political environments.
 
Overall, there appear to be four key roles for public health action on 
health determinants to reduce health inequities:
·         Assess and report on the health of populations describing the 
existence and impact of health inequalities and inequities and, effective 
strategies to address those inequalities/inequities.
·         Modify/orient public health interventions to reduce inequities 
including the consideration of the unique needs and capacities of priority 
populations (i.e., do planning and implementation of existing programs 
considering inequities).
·         Engage in community and multi-sectoral collaboration in 
addressing the health needs of these populations through services and 
programs (i.e., when looking at the collectivity of our programming for 
?x?, where are the gaps?).
·         Lead/participate and support other stakeholders in policy 
analysis, development and advocacy for improvements in health 
determinant/inequities??

 
Content:
Executive Summary 
1. Introduction .
2. Methodology 
3. Findings 
Context for Public Health Action on the Determinants of Health 
Key Concepts and Terminology 
Public Health?s Roots and History . 
Recent Major Reports Addressing Health Determinants and Equity ? Selected 
Examples . 
Formal Expectations for Public Health Action on Health Determinants and 
Health Inequalities/Inequities .
State of Public Health Action on Determinants of Health and Health 
Inequities 
Challenges to Public Health Action 
Opportunities (Reasons for Optimism) 
4. Analysis and Implications for Future NCCDH Actions 
5. Conclusion and Next Steps 

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