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Canadian Journal of Public Health = Revue Canadienne de Santé Publique logoLink to Canadian Journal of Public Health = Revue Canadienne de Santé Publique
. 2007 Jan 1;98(1):41–47. doi: 10.1007/BF03405384

Addressing the Non-medical Determinants of Health

A Survey of Canada’s Health Regions

C James Frankish 110,, Glen E Moulton 110, Darryl Quantz 210, Arlene J Carson 310, Ann L Casebeer 410, John D Eyles 510, Ronald Labonte 610, Brian E Evoy 210
PMCID: PMC6976051  PMID: 17278677

Abstract

Background

The Canadian health system is undergoing reform. Over the past decade a prominent trend has been creation of health regions. This structural shift is concurrent with a greater emphasis on population health and the broad determinants of health. In parallel, there is a movement toward more intersectoral collaboration (i.e., collaboration between diverse segments of the health system, and between the health system and other sectors of society). The purpose of this exploratory study is to determine the self-reported level of internal action (within regional health authorities) and intersectoral collaboration around 10 determinants of health by regional health authorities across Canada.

Methods

From September 2003 to February 2004, we undertook a survey of regional health authorities in Canadian provinces (N=69). Using SPSS 12.0, we generated frequencies for the self-reported level of internal and intersectoral action for each determinant. Other analyses were done to compare rural/suburban and urban regions, and to compare Western, Central and Eastern Canada.

Results

Of the 10 determinants of health surveyed, child development and personal health practices were self-reported by the majority of health regions to receive greatest attention, both internally and through intersectoral activities. Culture, gender and employment/working conditions received least attention in most regions.

Conclusion

The exploratory survey results give us the first Canadian snapshot of health regions’ activities in relation to the broad range of non-medical determinants of health. They provide a starting data set for baselining future progress, and for beginning deeper analyses of specific areas of action and intersectoral collaboration.

MeSH terms: Health care systems, health care reform, regional health planning; collaboration

References

  • 1.Eyles J, Brimacombe M, Chaulk P, Stoddart G, Pranger T, Moase O. What determines health? To where should we shift resources? Attitudes towards the determinants of health among multiple stakeholder groups in Prince Edward Island, Canada. Soc Sci Med. 2001;53:1611–19. doi: 10.1016/S0277-9536(00)00445-7. [DOI] [PubMed] [Google Scholar]
  • 2.World Health Organization. Intersectoral Action for Health: A Cornerstone for Health-For-All in the Twenty-First Century. 1997. [Google Scholar]
  • 3.Public Health Agency of Canada [homepage on the Internet]. Available online at: https://doi.org/www.phac-aspc.gc.ca/ph-sp/phdd/collab/ collab1.html (Accessed July 25, 2005).
  • 4.Hurley J. Regionalization and the allocation of healthcare resources to meet population health needs. Healthcare Papers. 2004;5(1):12–31. doi: 10.12927/hcpap..16836. [DOI] [PubMed] [Google Scholar]
  • 5.Frankish CJ, Kwan B, Ratner PA, Wharf Higgins J, Larsen C. Challenges of citizen participation in regional health authorities. Soc Sci Med. 2002;54(10):1471–80. doi: 10.1016/S0277-9536(01)00135-6. [DOI] [PubMed] [Google Scholar]
  • 6.Germann K, Wilson D. Organizational capacity for community development in regional health authorities: A conceptual model. Health Promot Int. 2004;19(3):289–98. doi: 10.1093/heapro/dah303. [DOI] [PubMed] [Google Scholar]
  • 7.Thurston WE, MacKean G, Vollman A, Casebeer A, Weber M, Maloff B, Bader J. Public participation in regional health policy: A theoretical framework. Health Policy. 2005;73:237–52. doi: 10.1016/j.healthpol.2004.11.013. [DOI] [PubMed] [Google Scholar]
  • 8.Public Health Agency of Canada [homepage on the Internet]. Available online at: https://doi.org/www.phac-aspc.gc.ca/aids-sida/hiv_aids/ federal_initiative/community/determinants.html (Accessed August 17, 2005).
  • 9.Keating DP, Hertzman C. Developmental Health and the Wealth of Nations: Social, Biological, and Educational Dynamics. New York: Guilford Press; 1999. [Google Scholar]
  • 10.Rutten A. The implementation of health promotion: A new structural perspective. Soc Sci Med. 1995;41(12):1627–37. doi: 10.1016/0277-9536(95)00013-W. [DOI] [PubMed] [Google Scholar]
  • 11.Labonte R. Healthy public policy: A survey of Ontario health professionals. Int Q Commun Health Educ. 1989;9(4):321–42. doi: 10.2190/EFW1-BP4V-HVX1-MN37. [DOI] [PubMed] [Google Scholar]
  • 12.Geva-May I, Maslove A. What prompts health care policy change? On political power contests and reform of health care systems. J Health Polit Policy Law. 2000;25(4):717–41. doi: 10.1215/03616878-25-4-717. [DOI] [PubMed] [Google Scholar]
  • 13.Lurie N. What the federal government can do about the nonmedical determinants of health. Health Affairs. 2002;21(2):94–106. doi: 10.1377/hlthaff.21.2.94. [DOI] [PubMed] [Google Scholar]
  • 14.Syme SL, Lefkowitz B, Kivimae Krimgold B. Incorporating socioeconomic factors into U. S. health policy: Addressing the barriers. Health Affairs. 2002;21(2):113–18. doi: 10.1377/hlthaff.21.2.113. [DOI] [PubMed] [Google Scholar]
  • 15.Casebeer A. Regionalizing Canadian Healthcare: The Good–The Bad–The Ugly. Health Care Papers: Regionalization of Health Systems. Healthcare Papers. 2004;5(1):88–93. doi: 10.12927/hcpap..16845. [DOI] [PubMed] [Google Scholar]
  • 16.Hinings CR, Casebeer A, Reay T, Golden-Biddle K, Pablo A, Greenwood R. Regionalizing healthcare in Alberta: Legislated change, uncertainty and loose coupling. Br J Management. 2003;4:S15–S30. doi: 10.1111/j.1467-8551.2003.00390.x. [DOI] [Google Scholar]
  • 17.Lewis S, Kouri D. Regionalization: Making sense of the Canadian experience. Healthcare Papers. 2004;5(1):12–31. doi: 10.12927/hcpap.2004.16847. [DOI] [PubMed] [Google Scholar]
  • 18.Lavis JN. Ideas at the margin or marginalized ideas? Nonmedical determinants of health in Canada. Health Affairs. 2002;21(2):107–12. doi: 10.1377/hlthaff.21.2.107. [DOI] [PubMed] [Google Scholar]
  • 19.Collins P. Addressing the social determinants of health: Understanding the role of values as facilitators and barriers to action. Hamilton, ON: McMaster University; 2004. [Google Scholar]

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