That’s contrary to what most Canadians believe, says Raphael in his new book , which looks at who stays healthy, who gets sick and why. It’s written with the goal of educating the informed Canadian, as well as university students.

Most people think luck, treatment options and lifestyle choices shape whether they are healthy or not. After all, that is the current mantra – eating better and exercising will lead to a healthier existence – a mantra that Canadians have wholeheartedly internalized. But that’s only part of the equation, and not the biggest part, says Raphael, a professor in 91��ɫ's School of Health Policy & Management in the Faculty of Health.

“Decades of research and hundreds of studies in Canada and elsewhere tell a different story: the primary factors that shape the health and well-being of Canadians – the factors that will give us longer, better lives – are to be found not in those much-discussed areas, but rather in the actual living conditions that Canadians experience on a daily basis,” says Raphael in About Canada: Health and Illness.

These factors include whether people are wealthy or poor, employed or not, working conditions, access to quality education, health and social services, and the basics of food and affordable housing. These social determinants “are crucial factors in the health and well-being of Canadians,” he says.

“Contrary to the assumption that we have personal control over these factors, in most cases these living conditions are – for better or worse – imposed upon us in the normal course of everyday life.”

Left: Dennis Raphael

That’s in large part because of the policies, regulations and laws enacted by governments at all levels, which influence employment income, family benefits and social assistance, as well as the quality and availability of affordable housing, health and social services, and recreational opportunities. That includes “what happens when Canadians lose their jobs during economic downturns such as the one that Canada began experiencing in 2008,” says Raphael.

“Governments also determine whether our children have access to affordable and high-quality child care and better-quality schools, the working conditions that we experience, and whether as seniors we receive levels of public pensions that allow us to live in dignity.”

Raphael wants to see changes in public policy that will affect Canadians’ health in a positive way. Through About Canada: Health and Illness, he wants the average Canadian to understand the role social determinants play in shaping health and what can be done to improve the situation through better public policies.

Raphael is the editor of , co-editor of and author of . He served as an adviser to the California Newsreel documentary series and the Deveaux Babin Productions Canadian documentary .

By Sandra McLean, YFile writer

Republished courtesy of YFile – 91��ɫ’s daily e-bulletin.

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Ritvo has pioneered a study, currently underway, that hopes to explore how mobile technologies such as BlackBerrys can be used as a way of reinforcing good health habits by facilitating ongoing feedback.

Harvey Skinner, the dean of 91��ɫ’s Faculty of Health and a colleague of Ritvo’s, says “motivational drift” can make it difficult for people to continue with healthy behavioural changes. “We start off with good intentions, maybe initiate a change, say an exercise program, and then days later, weeks later, months later, we start encountering some challenges in keeping to our goal and in keeping to the routine.”

The key, Skinner suggests, is ongoing feedback, and mobile technologies are a tool with the capacity to provide that kind of around-the-clock communication between a patient and a health provider.

According to Ritvo, the goal of the “engaged health coaching program” is to make the patients, who are part of a community that reports high rates of diabetes, to “really feel there’s somebody who is very concerned about your health, and is giving you the best information you can get at the times when you most need it.”

In the long run, this kind of care has the potential to reduce the strain on the health-care system.

“I see this as the first step of trying to apply it to a whole range of health problems, including depression, for example, where there wouldn’t be a physical problem, but there would be ways where people could alter their lifestyles so as to support their moods,” says Ritvo.

The complete article is available on the .

Republished courtesy of YFile– 91��ɫ’s daily e-bulletin.

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