Dennis Raphael knows who gets sick and why. But to make it better he needs you to know, too.

So the professor at York’s School of Health Policy & Management teamed up with visiting scholar Juha Mikkonen to produce a free public primer. Social Determinants of Health: The Canadian Facts is a 62-page report suggesting the primary factors shaping the health of Canadians are not medical treatments or lifestyle choices, but living conditions.

“We’ve been trying for years to put out something for the public,” says Raphael, “because the average person doesn’t go to Health Canada’s website or the Canadian Public Health Association website.”


Raphael credits his tech-savvy co-author in helping to get the message out. “With Juha visiting from Finland, I came across someone who not only had the content expertise, but was also able to master the desktop publishing and setting up of the website. Now when someone asks what it’s all about, instead of directing them to a World Health Organization report of 300 pages or my textbook of 600 pages, they can be directed to an accessible document.”

Since its launch on April the 28, has had more than 5,000 visitors, says Raphael.

Income, housing and social exclusion are three of the 14 social determinants of health the report identifies and seeks to improve. The notion that living conditions affect health is not new, but for some reason Canada has been slow to implement it into public policy, according to Raphael.

“I’m not making this up. If you were to type in social determinants of health you’d see that for 30 years Health Canada has been putting this stuff out. So this is really commonplace accepted information, but it’s been more acted upon in Europe and Australia at this point.”

Not surprisingly, Raphael and Mikkonen looked to Europe as a model. In 1998, the World Health Organization’s European office put out Social Determinants of Health: The Solid Facts. Reissued in 2003, the document was able to influence public policy in Europe, according to Raphael.

“Our thinking was that if they could do that in Europe and get the word out maybe we can do it Canada -- until the Canadian public begins to understand how important these issue are, there won’t be enough pressure on elected representatives to address the challenges that Canada is facing.”

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