Case 4 : Returning to Our Roots: Building Capacity in Public Health for Action on the Social Determinants of Health

Canadians are healthier than ever before, and live longer. But improvements in health are not distributed evenly between population groups. In fact, studies show that only 25% of our health is determined by health care and 15% by our genetics. The remaining 60% is determined by factors outside the traditional health care system, such as our income and social status, education, employment and working conditions, social support networks, social and physical environments, and culture. These factors are called the social determinants of health (SDOH). When these conditions are distributed in ways that are unfair, unjust, or avoidable, they are termed health inequities. These determinants can also be protective when everyone is given fair opportunities to access them. Because the SDOH cut across the purview of many sectors, such as education, health, socio-economic and public policy, understanding roles and responsibilities for health equity action remains a challenge. Within the Canadian public sector, difficulty translating health equity rhetoric into action has been noted despite the critical role public health organizations play in reducing health inequities. This case explores the development of organizational capacity to address the social determinants of health in a public health unit