1. Placing the Social Determinants of Health on the Public Policy Agenda
Toba Bryant and Dennis Raphael
Presentation at the Annual Meeting of the Canadian Public Health Association
Toronto, June 14, 2016

2. Basic Problem
Sustained Canadian research activity creating evidence on SDOH.
Government reports, public health and health care association statements, conferences and meetings concerned with SDOH.
Federal and provincial funding for SDOH research.
National Collaborating Centres.
Little impact on public policy.
Why is there little public policy implementation?

3. Why No Action?
Canadian governments’ natural inclination: “minimize government intervention” in the market economy – a typical liberal welfare state.
Knowledge dissemination on SDOH limited to public health professionals and policymakers rather than average Canadians.
Canadians generally unaware of the problem.
Governments under no pressure to act.

4. Solution?
Crack the “nut of health equity” through bottom-up action that forces top-down action.
Educate the public.
Build a social and political movement.
Recognize economic, social, and political barriers to a SDOH approach.
Embrace a politics of health and activities that grow from such an analysis.

5. Fran Baum, Cracking the nut of health equity: top down and bottom up pressure for action... Promotion & Education, 2007, 14, (2)

6. Making it Happen Start a real conversation about health.
Shift media discourse.
Recognize the opponents of a health equity approach.
Engage politicians.
Make the SDOH a do-or-die issue for governments.
Think of even more things to do.

7. Start a real conversation about health with Canadians

9. A Majority Of Ontario Units!
1. Chatham-Kent 2. Eastern Ontario 3. Elgin 4. Grey Bruce 5. Haldimand and Norfolk 6. Halton 7. Huron 8. Lambton 9. Leeds Grenville 10. Middlesex-London 11. Niagara
12. Oxford 13. Ottawa 14. Northwestern 15. Peterborough 16. Simcoe-Muskoka 17. Sudbury 18. Thunder Bay 19. Timiskaming 20. Wellington-Dufferin-Guelph 21. Windsor-Essex 22. York Region

11. Shift media discourse

12. Cargo Cults: Then and Now
With appreciation to Alex-Scott Samuel and Katherine Smith for the Insight.

17. Recognize the opponents of a health equity approach

20. Engage the politicians

21. 21

22. 22

24. Words of Wisdom from “The Who”
The change, it had to come We knew it all along…
I'll tip my hat to the new constitution Take a bow for the new revolution Smile and grin at the change all around Pick up my guitar and play Just like yesterday
Then I'll get on my knees and pray We don't get fooled again

25. Make the SDOH a do-or-die issue for governments

29. Think of even more things to do!

33. ?

34. Toba Bryant University of Ontario Institute of Technology toba
Toba Bryant University of Ontario Institute of Technology Dennis Raphael York University