1. THE SOCIAL DETERMINANTS OF HEALTH: A PUBLIC HEALTH PERSPECTIVE Lisa Simon, MD, MPH Simcoe Muskoka District Health Unit Intro to Sociology, Lakehead, Feb 5, 2015 Francis Vachon / THE CANADIAN PRESS

2. OVERVIEW Public health SDOH SDOH work at SMDHU

3. PUBLIC HEALTH Sector of the health system focused primarily on the health and well-being of the whole population through the promotion and protection of health and the prevention of illness Reducing health inequities increasingly seen as core to PH work Operates at federal, provincial, and local level  Local: www.simcoemuskokahealth.org www.simcoemuskokahealth.org

4. SOCIAL DETERMINANTS OF HEALTH (SDOH) Income and Income Distribution Education Unemployment and Job Security Employment and Working Conditions Early Childhood Development Food Insecurity Housing Social Exclusion Social Safety Net Health Services Aboriginal Status Gender Race Disability Source: Juha Mikkonen and Dennis Raphael, 2010

5. THE WHITEHALL STUDY Journal of Epidemiology and Community Health, 1978, 32, 244-249 Employment grade and coronary heart disease in British civil servants. M. G. MARMOT, GEOFFREY ROSE, M. SHIPLEY, AND P.J.S. HAMILTON. From the Department of Medical Statistics and Epidemiology, London School of Hygiene and Tropical Medicine

6. ESTIMATED IMPACT OF DOH ON POPULATION HEALTH STATUS

10. SMDHU’S WORK ON THE SDOH

11. 2012 – 2016 SMDHU STRATEGIC DIRECTIONS AND GOALS: THE DETERMINANTS OF HEALTH Address the factors that create inequities in overall health and improve the quality of life for populations at risk of poor health outcomes.

12. SMDHU HEALTH EQUITY FRAMEWORK http://www.simcoemuskokahealth.org/JFY/OurCommunity/DOH.aspx

13. MODIFY PUBLIC HEALTH INTERVENTIONS: HEALTH EQUITY IMPACT ASSESSMENTS

14. ENGAGE IN COLLABORATION: POVERTY REDUCTION COLLABORATIVES Collective Impact: the commitment of a group of actors from different sectors to a common agenda for solving a specific social problem, using a structured form of collaboration Comprehensive Community Initiatives: place-based, comprehensive approaches to reducing poverty and other complex socio-political problems

15. ADVOCACY FOR POLICY CHANGE: POVERTY Feedback submitted by SMDHU and as part of provincial Health Equity Working Group:  Ontario’s Poverty Reduction Strategy review  Ontario’s Minimum Wage review  Affordable Housing Plan reviews – Ont and local Facilitating public health discussions on advocacy for specific anti-poverty policies – e.g. guaranteed annual income

16. RESOURCES SDOH: The Canadian Facts  http://www.thecanadianfacts.org/ http://www.thecanadianfacts.org/ WHO Commission on the SDOH  http://www.who.int/social_determinants/en/ http://www.who.int/social_determinants/en/ National Collaborating Centre for Determinants of Health  http://www.nccdh.ca/ http://www.nccdh.ca/ National Collaborating Centre for Aboriginal Health  http://www.nccah-ccnsa.ca/en/ http://www.nccah-ccnsa.ca/en/ Upstream  http://www.thinkupstream.net/ http://www.thinkupstream.net/

17. THANK YOU