Research Bulletin January 2019: Social Determinants of Health

This month’s research bulletin focuses on articles and reports related to the social determinants of health—the social, economic, and political conditions that affect the health and wellbeing of people, communities, and populations.

The reports below provide an overview of current and recent research focused on the social determinants of health and their use as a framework for the development and implementation of social programs and policies and supports. They suggest ways existing efforts can be improved and offer new information, approaches, perspectives to increase the impact of social interventions.

  1. Taking stock of the social determinants of health (2017, CAN)
  2. Creating change in government to address the social determinants of health: How can efforts be improved? (2015, UK)
  3. FNHC Social Determinants of Health Discussion Guide (2017, CAN)
  4. Towards a global monitoring system for implementing the Rio Political Declaration on Social Determinants of Health (2018, UK)
  5. What has economics got to do with it? The impact of socioeconomic factors on mental health and the case for collective action (2018, US)

For more information, additional research, and/or if you have feedback about how we can make this member service more useful, please contact The Federation’s Research and Policy Coordinator, Pam Alcorn at pam@fcssbc.ca.

1. Taking stock of the social determinants of health

This article, by a team of researchers based out of the University of Calgary, shares the results of a literature review of 108 academic and grey research papers about the Social Determinants of Health. It attempts to bring clarity to this multi-faceted concept—the key elements, how they operate, and how they can be addressed through social policy.

They define and explain the social determinants of health—the social, economic and political conditions that affect people and populations—and argues why adopting such a lens or framework is vital for wide-spread health promotion. They also explain that this work requires a difficult shift from focusing on “individual-level” factors to community and societal factors.

The article provides valuable research that can inform many current discussions about the value of social services as well as the need for cross-sector and cross-ministry collaborative work on policy development and implementation. It also provides useful descriptions of key terms used in the design and evaluation of social policies and programs.

2. Creating change in government to address the social determinants of health: How can efforts be improved?

This research paper recognizes the growing complexities of social and public health issues and aims to draw evidence-based lessons from previous governmental programs and policies that incorporate the social determinants of health.

Their main finding is that, for such efforts to be as successful as possible, they require a “whole-of-government” response that goes much further than simply identifying problems and choosing appropriate tools. According to the authors, maximizing impact also requires high-level political support, formal authority, collaboration across government silos, the inclusion of front-line service providers, and clear accountability mechanisms.

For those working towards the creation of a Social Policy Framework for British Columbia, this report offers insights into how such a process could (or should) unfold and highlights elements and approaches that will help to address the breadth and complexity of such an initiative.

3. Social Determinants of Health Discussion Guide

This discussion guide was created by the First Nations Health Council to support discussions about the social determinants of health and show links between specific social issues (e.g., poverty, early childhood experiences) and overall health.

The guide acknowledges the recent realization within “mainstream” science that health is “largely determined by the conditions in which we grow, live, work and age” and demonstrates how different factors can affect health throughout our lifespans. The authors present their case for collaborative, comprehensive, and integrated care with a full continuum of services and conclude with a proposal to collaboratively a 10-year strategy to accomplish that goal.

Given our province’s commitment to reconciliation, this guide offers insights into First Nation perspectives on health and wellness and can help inform how services and policies are planned, developed, and implemented in BC.

4. Towards a global monitoring system for implementing the Rio Political Declaration on Social Determinants of Health

This paper reports on the efforts of a World Health Organization working group to identify high-quality indicators and metrics for capturing and tracking government action related to addressing the social determinants of health.

Though it is somewhat dense, this report will be useful to those interested in ways to (1) track and measure the programs, services, and systems that are aiming to address complex social issues, and (2) build evidence to better support effective actions that are addressing health inequities.

It offers implications for research and practice which will resonate with those working on program design and policy development as well as those researching “under-studied” interventions related to the social determinants of health (which may require new and novel approaches).

5. What has economics got to do with it? The impact of socioeconomic factors on mental health

This report provides a review of research related to social determinants of mental health. The authors examine implications at both individual and societal levels while illuminating the ways social determinants of health can inform the prevention and treatment of mental health challenges.

In order to address mental health inequalities, the authors argue that we need to shift our focus from an individual’s personal mental health state toward broader actions in the realms of policy, community, and service provision while also beginning to shift the framework of our analyses from psychological to economic.

Their review of contemporary research on mental health focuses on the important role socioeconomic factors play when it comes to mental health equality. They also provide recommendations for moving from evidence to action and explore the barriers to addressing “upstream” economic factors that more broadly affect mental health.