Abstract
A challenging budget environment during the Harper years has meant that crucial investments in the social determinants of health (SDHs) have increasingly been neglected. The tabling of what is widely considered a more progressive budget with expansionary fiscal elements under the new Prime Minister, Justin Trudeau, raises the question as to what extent this budget invests in policy areas that are crucial for achieving a more equitable distribution in the social determinants of health, as promised in the Liberal party platform. In this commentary, we argue that the first Liberal budget represents a step in the right direction, but that this first step needs to be followed up with a sustained commitment to address the pervasive (and unfair) social inequalities that are the root cause of persistent health inequities in Canada. We conclude that the first Trudeau budget, while moving in the right direction, does not fully embody the sustained policy changes needed to effectively address SDHs, including a more expansive role for the federal government in the redistribution of income and wealth.
Key words: Public health, budgets, social determinants of health
Résumé
En raison d’un contexte budgétaire difficile durant les années Harper, des investissements cruciaux dans les déterminants sociaux de la santé (DSS) ont été de plus en plus négligés. Avec le dépôt de ce qui est généralement considéré comme un budget plus progressiste, comportant des éléments expansionnistes, sous la direction du nouveau premier ministre Justin Trudeau, il est permis de se demander dans quelle mesure ce budget investit dans les secteurs de dépenses décisifs pour obtenir une distribution plus équitable dans les déterminants sociaux de la santé, comme promis dans la plateforme du Parti libéral. Dans notre commentaire, nous faisons valoir que le premier budget libéral représente un pas dans la bonne direction, mais que ce premier pas doit être suivi par un engagement soutenu à aborder les inégalités sociales omniprésentes (et injustes) qui sont la cause profonde d’iniquités persistantes face à la santé au Canada. Nous concluons que le premier budget Trudeau, bien qu’il aille dans la bonne direction, n’incarne pas pleinement les changements d’orientation soutenus qui sont nécessaires pour aborder efficacement les DSS, notamment l’attribution d’un rôle plus large au gouvernement fédéral dans la redistribution des revenus et de la richesse.
Mots clés: santé publique, budget, déterminants sociaux de la santé
Footnotes
Source of funding: The research leading to this commentary was made possible through financial support provided by the Canadian Institutes of Health Research (Operating Grant Nr.136927).
Conflict of Interest: None to declare.
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