Social determinants of health


Primary responsibility for Country Partner work in Canada was with the Public Health Agency (PHAC) under the leadership of the Deputy Chief Public Health Officer, Health Promotion and Chronic Disease Prevention. A new group, the Strategic Initiatives and Innovations Directorate, was established to be responsible for orchestrating the response to the Commission. The team led action on the social determinants of health through global and national partnerships, strategic initiatives and informing policies in other sectors and levels of government.

Canadian Reference Group on Social Determinants of Health (CRG)

The team also provided analytical and secretariat support to the Canadian Reference Group on Social Determinants of Health (CRG). The CRG, chaired by the Deputy Chief Public Health Officer, included Canada’s Commissioner, leads from two Knowledge Networks, representatives from federal government departments, provincial representatives, academics and NGO leaders.

The mandate of the CRG was to inform Canada’s contribution to the Commission, to integrate lessons learned from the Commission into Canadian policy, and to mobilize action in Canada.

Addressing the social causes of illness

Panel discussion hosted by Canada’s International Development Research Centre (IDRC) by Stephen Dale: looking beyond genes and germs, health and economics, budgeting for better health. THIS DOCUMENT MISSING

Goal 1: Expand the knowledge base

Under this goal two thematic areas were worked with support of the government of Canada:

  • Intersectoral action work, and
  • Aboriginal Peoples' Health.

Intersectoral action

This work focused on improved knowledge on contexts, tools, mechanisms and approaches for intersectoral action for health and equity. Under this initiative the Canadian government in partnership with WHO:

  • Conducted 8 Canadian case studies to characterize contexts, approaches, and mechanisms used for intersectoral action for health and equity.
  • Partnered with WHO Secretariat to lead a literature review on global experiences with intersectoral action on health and equity and coordinated the development of case studies involving 20 low, middle and high income countries and the EU.
  • Hosted a two-day dialogue to surface learnings from the case studies and suggest directions for future collaborative work.
  • Released in partnership with WHO two reports on intersectoral action in 2007 and 2008.

Aboriginal peoples' health

Canada took the lead to increase the knowledge on determinants of Aboriginal peoples’ health including self-determination as a determinant of health. Specifically Canada:

  • Convened a roundtable dialogue among Aboriginal stakeholders in Canada.
  • Commissioned 3 papers – one from each of the main groups of Aboriginal peoples in Canada (First Nations, Metis and Inuit) - detailing determinants of Aboriginal Peoples’ health and policy approaches for addressing health inequalities. Distilled these papers into a synthesis paper for an Indigenous Health Symposium in Adelaide.
  • Participated in Indigenous Symposium in Adelaide and sponsored involvement of participants from 6 countries.
  • Presented results/findings to WHO Commissioners in June 2007.

Goal 2: Increase awareness and support among the public and decision-makers

This goal encompassed two specific objectives:

  • Building an economic case for investment in SDH and
  • Improve collaborative engagement of civil society to raise awareness of SDH among the public and decision makers.

Building an economic case

This area of work encompassed the following activities:

  • Partnering with WHO, England, Sweden and Chile to explore this issue. Attended October 2006 meeting (see link below for more) in London, followed up by an informal meeting in June 2007 in Vancouver.
  • Examined existing evidence in Canada which contributes to an economic case for upstream investments and possible strategies for using these arguments within the Canadian political context.
  • In addition to research and literature reviews, PHAC hosted a Roundtable titled Developing a Canadian Economic Case for financing the Social Determinants of Health. It included a wide range of health and economic experts and policy advisors from NGOs and federal government departments.

A final report is currently being prepared which will inform PHAC’s next steps in this area.

Improve engagement of civil society

Activities undertaken included:

  • Convened meeting of 50 national, regional and community organizations involved in addressing SDH to share information and discuss opportunities for collaborative work.
  • Developed a civil society engagement and communications plan.
  • Commissioner Monique Bégin and CRG raised awareness of SDH through participation in conferences and speaking engagements

Commissioner Bégin

Commissioner Bégin
Commissioner Bégin

Monique Bégin is a sociologist and the first woman from Québec elected to the House of Commons, Canada. She was twice appointed Minister of National Health and Welfare and remains best known for the Canada Health Act.

Goal 3: Contribute to systemic change

This goal encompassed the following activities: The CRG’s vision included systemic change in policy processes and structures. For this reason, the CRG supported Commissioner Bégin’s efforts to solicit interest of a Senate sub-committee to undertake a study of this subject. A Senate Committee on Population Health was established and is carrying out research and hearings.

The Senate will make a recommendation to Parliament regarding approaches and investments to address SDH across departments of government. This committee has released two interim reports on its study on determinants of health.

The CSDH served as an important catalyst to advance relevant knowledge development and policy analysis in Canada. A significant result has been increased focus and priority placed on the role of the health sector (especially public health) in leading cross-governmental action on SDH.

A determinants and health inequalities focus has been included in the PHAC five year strategic plan and the agency’s past two annual reports on plans and priorities. An Action Framework is currently under development which outlines PHAC’s role in advancing action on SDH within the health sector and in collaboration with other sectors.


Canada’s participation and response. Addressing health disparities in Canada through intersectoral action on the social determinants of health: presented by Public Health Agency of Canada.