Health Nexus (formerly OPC) is Ontario's leading bilingual health promotion organization.

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Web Coverage - Day 2 - Morning concurrent dialogue

2A – Where are the determinants of health?

Panelists

Carmen R. Connolly
President, Carmen R. Connolly Consulting Inc.
Board Member, Ontario Prevention Clearinghouse

Stephen Samis [Presentation]
Director, Health Policy, Heart and Stroke Foundation of Canada

"Look for champions in your organization - they are there -... help peers to bring them to a comfort zone on determinants of health issues."

Sandra Laclé [Presentation]
Interim Director, Clinical Services Division, Sudbury & District Health Unit

"For us in the public health community, we have an "ah-ha" moment. While we are leaders in health promotion and individual behaviour change, we know that we have not effectively and consistently led the way in addressing what really affects our health - poverty, housing, environmental determinants."

Session summary

Stephen Samis provided an inside look at the organizational changes that the Heart and Stroke Foundation (HSFC) has undertaken to integrate a health determinants perspective. HSFC acknowledges health determinants. However, until 2005, it had not addressed determinants in research, health promotion or advocacy.
Change has started:

Created a strategic research fund to look at priorities of obesity, resuscitation, stroke and evaluation
Using the Ottawa Charter for health promotion as a foundation
Working with the Chronic Disease Prevention Alliance of Canada (CDPAC) which can collectively speak out on determinants, without affecting individual mandates and missions of member organizations

Lessons learned:

Identify opportunities to address determinants (tie to mission, policies, champions)
Addressing determinants of health can be threatening - find comfort level and fit
Work to bring others on side through use of evidence and "frame" for addressing key determinants
Focus on one or more determinants but not all - too hard
Work in collaboration with others on the spectrum of determinants
One step can lead to another

Sandra Lacle of the Sudbury & District Health Unit said there is an increasing awareness of the need for public health to address determinants of health in their work - but it is a difficult undertaking.

The Sudbury District Health Unit hosted a determinants of health 'stream' at the 2005 Ontario Public Health Association (OPHA) and Association of Local Public Health Agencies (alpha) conference.

In order for a revitalized public health system in Ontario to have a clear role in working to address social and economic factors, there needs to be mandate, structural support interministerially, overarching common goals and paying attention to signs.

The image of a stop light 'tree' simultaneously showing green, yellow and red, was used to highlight the signs for public health to move ahead, be cautious and understand the blockages.

Green lights:

Local public health leadership
Competencies and governance
Political and community receptivity
Partnerships
Public health is a credible voice on local issues

Red lights:

Belief that determinants are ideological and therefore illegitimate
Belief that public health mandate, scope and workforce do not cover determinants
Gaps in evidence and knowledge transfer

At the conference, the public health resolution passed calling for policy changes and local supports for determinants. The challenge is not just for public health but for all of us to see how to integrate determinants into our work.