Abstract
SETTING: The World Health Organization Commission on the Social Determinants of Health (SDoH) observes that building political will is central to all its recommendations, because governments respond to those who organize and show up. Since younger Canadians are less likely to vote or to organize in between elections, they are less effective at building political will than their older counterparts. This results in an age gap between SDoH research and government budget priorities. Whereas Global AgeWatch ranks Canada among the top countries for aging, UNICEF ranks Canada among the least generous OECD (Organisation for Economic Co-operation and Development) countries for the generations raising young children.
INTERVENTION: A surgical intervention into the body politic. Guided by the “health political science” literature, the intervention builds a non-profit coalition to perform science-based, non-partisan democratic engagement to increase incentives for policy-makers to translate SDoH research about younger generations into government budget investments.
OUTCOMES: All four national parties integrated policy recommendations from the intervention into their 2015 election platforms. Three referred to, or consulted with, the intervention during the election. The intervention coincided with all parties committing to the single largest annual increase in spending on families with children in over a decade.
IMPLICATIONS: Since many population-level decisions are made in political venues, the concept of population health interventions should be broadened to include activities designed to mobilize SDoH science in the world of politics. Such interventions must engage with the power dynamics, values, interests and institutional factors that mediate the path by which science shapes government budgets.
Key Words: Knowledge translation, health policy, social determinants of health
Résumé
LIEU: La Commission des déterminants sociaux de la santé (DSS) de l’Organisation mondiale de la santé observe que la création d’une volonté politique est au cœur de toutes ses recommandations, car les gouvernements répondent à ceux qui s’organisent et qui sont visibles. Comme les jeunes Canadiens sont moins susceptibles de voter ou de s’organiser entre les élections, ils réussissent moins bien à susciter une volonté politique que leurs compatriotes plus âgés. Cela creuse un fossé des âges entre la recherche sur les DSS et les priorités budgétaires gouvernementales. Global AgeWatch classe le Canada parmi les meilleurs pays où vieillir, mais l’UNICEF le classe parmi les pays les moins généreux de l’OCDE (Organisation de coopération et de développement économiques) envers les générations qui élèvent de jeunes enfants.
INTERVENTION: Une intervention chirurgicale dans le corps politique. Guidée par la documentation sur la «science politique de la santé», cette intervention crée une coalition à but non lucratif pour faire de la mobilisation démocratique apolitique fondée sur la science afin d’inciter les responsables des politiques à traduire la recherche sur les DSS des jeunes générations en investissements budgétaires gouvernementaux.
RÉSULTATS: Les quatre partis nationaux ont intégré les recommandations de principe de l’intervention dans leurs plateformes électorales de 2015. Trois d’entre eux ont fait référence à l’intervention, ou en ont consulté les responsables, durant l’élection. L’intervention a coïncidé avec l’engagement de tous les partis à opérer la plus grande hausse annuelle des dépenses en faveur des familles avec enfants en plus d’une décennie.
CONSÉQUENCES: Comme de nombreuses décisions au niveau des populations sont prises dans l’arène politique, il faudrait élargir le concept des interventions en santé des populations pour inclure des activités visant à mobiliser la science des DSS dans le monde de la politique. De telles interventions doivent aborder la dynamique du pouvoir, les valeurs, les intérêts et les facteurs institutionnels qui aplanissent la voie à la science pour qu’elle puisse influencer les budgets gouvernementaux.
Mots Clés: application des connaissances, politique de santé, déterminants sociaux de la santé
Footnotes
Conflict of Interest: None to declare.
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