The Social Determinants of Health: Capacity Building and Awareness Raising Resource
The World Health Organization, in its report Closing the gap in a generation: Health equity through action on the social determinants of health (WHO SCDH p.1) states:
“Traditionally, society has looked to the health sector to deal with its concerns about health and disease…But the high burden of illness responsible for premature loss of life arises in large part because of the conditions in which people are born, grow, live, work and age…Action on the social determinants of health must involve the whole of government, civil society and local communities, business, global fora, and international communities.”
In recent newsletters, we have reported on a number of Canadian initiatives to support families living in poverty/at high risk under the priority categories listed below. At policy level, provincial/territorial legislation in Ontario, New Brunswick, Nova Scotia and Nunavut is mandating cross-sector cooperative strategies to address the complex social issues around health equity. The National Collaborating Centre for Determinants of Health work on identifying and refining the 4 Roles approach is helping to create a structure for setting up multi-sector discussions of SDH and health equity issues at national, provincial and community levels. We have also seen how collaborative work is being done locally, for example through the Kimberley Ages & Stages Community Pilot Project, and in the work being coordinated through Richmond Children First to set up an
Early Childhood Development Community Framework for the City of Richmond.
At an international level, EuroHealthNet, in collaboration with the International Union on Health promotion and Education (IUPHE), identified six priority areas to build capacity to address the Social Determinants of Health (SDH) and to improve health equity.
Their interactive guidance document Menu for Capacity Building & Awareness Raising Actions includes a range of suggestions for actions that can be taken to facilitate efforts to address the SDH and to improve health equity, along with resources that can be applied to support these actions.
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Priority Area 1: AWARENESS RAISING and ADVOCACY
- Collect compelling information and use it to develop advocacy material on the SDH and health inequalities, incorporating information that is relevant to your country.
- Develop a stakeholder map and an advocacy strategy and implement elements of this strategy.
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Priority Area 2: DEVELOP THE INFORMATION AND EVIDENCE BASE
- Improve information systems to describe, measure, understand, analyse and track inequities in health.
- Develop the evidence base by improving and generating more evaluation on measures that address the SDH and health equity and/or economic assessments (e.g. cost/benefit analysis) in this area.
- Identify good practice on how to address the SDH and improve health equity and assess transferability.
- Make existing data and evidence available and accessible to others.
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Priority Area 3: ORGANIZATIONAL DEVELOPMENT
- Undertake a baseline analysis of existing activities and structures in your organisation to address the SDH and health inequalities and share this with decision makers in your organisation.
- Identify resources that are available to your organisation, region and/or country to take action on the SDH and health equity and share this information with other potential users.
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Priority Area 4: SKILLS DEVELOPMENT
- Develop and provide training on SDH and health equity to appropriate people in your organisation, region and/or country.
- Ensure that quality training on SDH and health equity is incorporated into undergraduate and postgraduate studies for health professionals.
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Priority Area 5: PARTNERSHIP DEVELOPMENT AND LEADERSHIP
- Identify how the public health, health promotion and health care sectors can improve their collaboration and provide greater leadership on the SDH.
- Scope potential partners and initiatives in other sectors that affect health equity, identify common objectives and identify and act on priority areas.
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Priority Area 6: POLICY DEVELOPMENT
- Undertake a policy assessment on the SDH and health inequalities and assess to what extent existing mandates are being put to practice.
- Explore how to mainstream action on the SDH in policy making processes and how to enhance implementation through cross-sectoral structures and other tools and mechanisms.
- Ensure greater coherence between policies and actions taking place at the national, regional and the local level.
This document, as well as providing a wide range of useful resource links, creates a framework into which individual initiatives can be set. Along with a detailed step-by-step breakdown to approach each of the priority area categories, links are provided to practical tools such as Improving Health and Reducing Inequalities: A practical guide to health impact assessment, a detailed guide on how to use the health impact assessment approach in organizations.
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