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See also: http://journal.cpha.ca/index.php/cjph/article/download/1135/1135
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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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