social determinants of health Archives | Research & Innovation

Experts wanted: 91��ɫ's Knowledge Mobilization Unit helps United Way 91��ɫ Region

fmaquito — Tue, 08 Nov 2011 10:00:00 +0000

Two upcoming events hosted by the United Way 91��ɫ Region have a special connection to 91��ɫ's Knowledge Mobilization Unit.

The first is a community forum tomorrow, Nov. 9 to discuss food policy and the development of a food charter for 91��ɫ Region. The second event on Tuesday, Nov. 29, features a community dialogue on pressing social issues facing the region. Members of the 91��ɫ community are invited to both events.

Since September, a knowledge broker placed at the United Way 91��ɫ Region has been working in close partnership with the University's Knowledge Mobilization Unit to enhance opportunities for collaboration in research with respect to social determinants of health. The partnership is the result of a successful application to the Canadian Institutes of Health Research submitted in February 2011. (Knowledge brokers are project staff acting as intermediaries that connect researchers to potential research users.)

“This is a tremendous opportunity to maximize the impact of 91��ɫ research and build on a significant partnership for 91��ɫ in knowledge mobilization,” said Michael Johnny (right), manager of 91��ɫ’s Knowledge Mobilization Unit.

The Nov. 9 forum, , hosted by the United Way 91��ɫ Region in collaboration with various partners, will bring together representatives from a number of community organizations to discuss food security and agriculture issues. Participants will also embark on a discussion about establishing a Food Charter for 91��ɫ Region.

A food charter is a statement of values and principles to guide a community’s food policy, and is a key document for communities working towards developing a food system that is healthy, equitable and sustainable. The organizers of Food for Change are hoping that academic partners from 91��ɫ will attend the event and engage in a dialogue to explore ways that research can inform and support this initiative in both the short and longer term.

On Nov. 29, the United Way 91��ɫ Region will host the , part of a series of community dialogues on pressing social issues in 91��ɫ Region. During the meeting house, participants will explore the implications for social infrastructure development in communities that are facing major population growth. Over the next few months, meeting house dialogues will also be held in Newmarket, Vaughan, Markham and Richmond Hill.

“Working within Canada’s leading knowledge mobilization university, 91��ɫ’s Knowledge Mobilization Unit continues to work together with our partners to make 91��ɫ’s research and talent accessible and relevant to the community,” said Robert Haché, vice-president research & innovation. “This partnership will help facilitate initiatives to improve the quality of life for residents in 91��ɫ Region.”

For more information on knowledge mobilization services at 91��ɫ, or about this partnership, e-mail 91��ɫ's Knowledge Mobilization Unit at kmbunit@yorku.ca.

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

The post Experts wanted: 91��ɫ's Knowledge Mobilization Unit helps United Way 91��ɫ Region appeared first on Research & Innovation.

Poverty makes us sick; Professor Dennis Raphael says it should make us angry

fmaquito — Mon, 10 Jan 2011 10:00:00 +0000

The sky in Lawrence Heights is low and the horizon is as wide as it gets in the city; no skyscrapers here. Dennis Raphael and I were walking through the neighbourhood on a chilly day, wrote columnist :

He is a professor of health policy & management in 91��ɫ University’s Faculty of Health, and he is an observant guy. No skyscrapers?

“Downsview,” he said.

I should have known. The airport; incoming likes it low. But there are other features of the neighbourhood that are much more notable, in particular the overlapping of the maps of poverty, illness and crime.

What kind of poverty? Crushing. What kind of crime? You name it. How about illness?

Let’s talk diabetes. Everyone’s talking about it these days. The national public broadcaster even has a bunch of people eating lettuce and doing jumping jacks on TV.

Is it lifestyle? Fooey.

Raphael did a health study in a while back. His findings show that the correlation [of poverty and poor health] is not between the couch and the potato. “People who are poor don’t have the resources to be healthy. Diabetes is three or four times more likely to occur among poor people.”

He talked freely as we walked along. “We interviewed low-income people. We were struck, when we did the study, by how unable people were to access resources: the poor don’t go to ball games, to movies. They never spoke of recreation, of volunteering, of going out with friends.In other words, the poor have fewer ways to relieve their stress, and stress is a factor of the disease of diabetes, and I don’t know any poor people who are relaxed.

I was going to ask about other factors when he said something that is encouraging and ridiculous at once.

“People with life-threatening illnesses overwhelmingly say they get good health care. And most people on disability get free meds, diabetes test strips, monitors, feet and eye exams; and, overwhelmingly, they had public housing.” That’s the good news.

“But even with those pluses, we found that 72 per cent of the people we surveyed couldn’t afford the food they needed to be healthy.” He wasted no time in pointing out the irony: “The health care system will treat you fine if you keel over, but we won’t provide you with the resources you need to avoid getting sick.”

An easy fix?

“People are suffering, but I see little evidence that things are getting better.” I shivered, not from the cold. We passed a solid little building. He said, “The community health centre here is great. And the Community Care Access Centre is great.”

His proof?

“The people in our study knew about blood monitoring.” That, by the way, is a constant for diabetics. “And they knew about eating healthy food. But we found they didn’t have the money to afford the food they needed.”

That’s an outrage, or it ought to be.

I noted that some people seem to think that if you are fat, you are more prone to diabetes. Raphael hammered away at his original theme: “It isn’t whether you are fat, it’s whether you are poor.

“Countries that have low poverty rates are countries that give things like child care, tuition, decent social assistance.” These are countries where — surprise, surprise — people’s health is generally better.

“But in countries like ours, where there is a good chance of being poor, you don’t get those things — you don’t get universal child care; you don’t get good, solid employment insurance.”

Funny how we say we can’t afford first-rate social programs, and yet many of our neighbours haven’t got the money they need to be healthy. The dots ought to be easy to connect.

Raphael has published extensively about the , and the social determinants of health in Canada and internationally.

Posted by Elizabeth Monier-Williams, research communications officer, with files courtesy of YFile – 91��ɫ’s daily e-bulletin.

The post Poverty makes us sick; Professor Dennis Raphael says it should make us angry appeared first on Research & Innovation.

Diabetes crisis in Jane-Finch neighbourhood focus of 91��ɫ-led community forum on November 11

fmaquito — Thu, 11 Nov 2010 10:00:00 +0000

The high level of Type 2 diabetes in the Black Creek neighbourhood of northwest Toronto is imposing tremendous pain and suffering on a largely visible minority population, according to community health workers, researchers and educators who will meet Thursday at a community forum to begin developing an action plan to combat the disease.

91��ɫ's Health Leadership & Learning Network has partnered with the Black Creek Community Health Centre and the to bring members of the community together for the Diabetes: Perspectives for Action – Community Forum on Nov. 11, from 6 to 8pm at Westview Centennial Secondary School, 755 Oakdale Rd., North 91��ɫ.

Right: Maps of Toronto show the overlap between the areas of low income, visible minorities and the incidence of diabetes. Click maps to see interactive version. Courtesy of the Toronto Star

The forum will discuss the increasing incidence of Type 2 diabetes in the Jane-Finch neighbourhood, strategies to prevent it and community resources to improve the health of people living with the disease.

Income inequality is on the rise in Canada along with a parallel increase in diabetes mortality, especially in low-income neighbourhoods such as Jane-Finch, according to a recent 91��ɫ study that has been published online and will appear in an upcoming issue of the journal Health Policy.

Dennis Raphael, a professor in the School of Health Policy & Management at 91��ɫ and a co-author of the study, says it clearly shows that low income is associated with a higher risk of developing the disease, even when other risk factors such as obesity are taken into account. Separate maps of Toronto that show areas of low income, visible minorities and the incidence of diabetes clearly show the overlap between the three, says Raphael, who will speak first at the event.

Three representatives of the Black Creek Community Health Centre will speak about their work in the community. Community health worker Michelle Westin will discuss her experiences helping residents to identify and address issues related to diabetes prevention and management. Lisa Martin, a registered dietitian and certified diabetes educator, will speak about the importance of access to adequate resources in managing diabetes, as well as healthy lifestyle choices. Carla Da Mota, a diabetes nurse educator who has witnessed an increase in both the number of clients with diabetes and complications they experience due to poorly managed diabetes, will talk about her experiences in promoting prevention and management of the disease through education.

Professor Lesley Beagrie, associate dean, professional & global programs in 91��ɫ's Faculty of Health, will moderate the panel.

The Toronto District School Board has recently launched a Diabetes Awareness Strategy. Annie Appleby, superintendent of education for Ward 1 in the northwest part of Toronto – where the incidence of Type 2 Diabetes is at eight per cent – will speak about the schools' efforts to promote healthy choices and change the behaviours of staff, students, and even families.

For more information, visit the website.

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

The post Diabetes crisis in Jane-Finch neighbourhood focus of 91��ɫ-led community forum on November 11 appeared first on Research & Innovation.

Professor Dennis Raphael: Getting sick is more about living conditions than lifestyle

fmaquito — Fri, 24 Sep 2010 08:00:00 +0000

What makes us sick? Is it genetics or lifestyle? Is it too many burgers, too much alcohol, not enough exercise? Not according to 91��ɫ Professor Dennis Raphael, who, like the fourth-century BC philosopher Plato, attributes poor health to living conditions. Things like income level and people’s access to food, housing, education, and health and social services, are what determines whether people are ill or healthy, he says.

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.

The post Professor Dennis Raphael: Getting sick is more about living conditions than lifestyle appeared first on Research & Innovation.

Canada's health policies failing its most vulnerable, researchers find

fmaquito — Tue, 11 May 2010 08:00:00 +0000

Dennis Raphael, a professor in 91��ɫ’s School of Health Policy & Management in the Faculty of Health was quoted in the Aurora Banner's May 8 issue about his report, released April 29, that offers Canadians the opportunity to learn how their living conditions will determine whether they stay healthy or become ill:

We’re products of our environment and our living conditions determine if we stay healthy or become ill, a 91��ɫ study says.

“Health and poverty are directly linked,” Vaughan Community Health Centre executive director Isabel Araya said in response to Social Determinants of Health: The Canadian Facts. “The poorer you are, the sicker you are.”

The report, co-authored by Dennis Raphael, a professor in 91��ɫ’s School of Health Policy & Management in the Faculty of Health, and visiting scholar Juha Mikkonen, finds conditions are deteriorating, with serious ramifications for the quality and longevity of Canadians’ lives, particularly the poor.

The study profiles how our health is shaped by how much income and wealth we have, if we’re employed and, if so, the working conditions we experience. The researchers pull together a range of data to show how health is powerfully influenced by our ability to obtain quality education, food and housing, among other factors.

The complete .

on the report May 11:

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

So the professor at 91��ɫ’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.”

also covered the study April 28:

A 91��ɫ study has found enormous gaps in the quality of life and health among Canadians, and those lines are largely drawn along income and wealth.

The 62-page report found that while Canada is among the richest countries in the world, it’s more than willing to let its poorest citizens fend for themselves when hard times strike.

Noting that an average person’s health can be determined by a number of factors, including housing, food security, social exclusion and income, the report claims Canada’s safety net isn’t sufficient.

The cumulative effect of these inequalities, the report says, is inferior public health, increased expenditure on front-line health care and increased mortality.

The complete article is .

Posted by Elizabeth Monier-Williams, with files courtesy of YFile– 91��ɫ’s daily e-bulletin.

The post Canada's health policies failing its most vulnerable, researchers find appeared first on Research & Innovation.

Researchers' report details how living conditions determine health of Canadians

fmaquito — Thu, 29 Apr 2010 08:00:00 +0000

A report released yesterday by 91��ɫ researchers offers Canadians the opportunity to learn how their living conditions will determine whether they stay healthy or become ill.

shows why these factors are so important for health and documents the state of living conditions in Canada in an accessible manner for the Canadian public. The report finds these conditions are deteriorating, with serious ramifications for the quality and longevity of Canadians' lives, and outlines specific ways that the situation can be improved. The report is free to the public to read or download. Printed copies are also available to .

"Our key message is that the health of Canadians is much less determined by the health-care system than we typically think. Much more important are public policies that influence our living conditions," says Dennis Raphael, a professor in 91��ɫ's School of Health Policy & Management in the Faculty of Health and the report's co-author.

Raphael and Juha Mikkonen, a visiting scholar at 91��ɫ, explain in everyday language and with compelling graphics how Canadians' health is shaped by how much income and wealth they have, whether or not they are employed and, if so, the working conditions they experience. They pull together a wide range of research to show how health is powerfully influenced by Canadians' ability to obtain quality education, food and housing, among other factors.

Contrary to the popular belief that Canada is a caring nation with strong supports for its citizens, the report shows that Canada has one of the worst records among wealthy, developed nations in providing its citizens with the conditions necessary for health. These supports are eroding with significant effects on Canadians' health, says Raphael.

Left: Dennis Raphael

"This is not a storyline that's familiar to most Canadians. We're still stuck in those glory days where Canada really was one of the best places in the world to live. Sadly, that is no longer the case. What's frightening is that many of these aspects are completely beyond any one individual's control."

For example, new immigrants have difficulty getting accreditation for their skills, and are forced into service jobs where they can barely afford to feed their families. This leads to a host of problems that directly affect health and overall quality of life. "It's all interrelated. It's time to act on these issues," Raphael says.

Another striking example is found in maps that show a clear correspondence between poverty levels, prevalence of adult-onset diabetes and concentration of visible minorities in Toronto neighbourhoods.

Right: Juha Mikkonen

The report was inspired by the 2003 World Health Organization document Social Determinants of Health: The Solid Facts. Raphael hopes it will also spur the public into action. "It really is oriented toward building a social movement," he says.

The report provides concrete recommendations for improving the situation. For example, with regard to the increasing occurrence of hunger in Canada, it recommends increasing minimum wages and social assistance rates to the level where an adequate diet is affordable and that government assure healthy foods, such as milk, fruit and foods high in fibre, are affordable. It also recommends there be a provision of affordable housing and child care that would reduce other family expenses and leave more money for acquiring an adequate diet.

Sobering statistics cited by the report include:

15 per cent of Canadian children are living in poverty, putting Canada at a rank of 20th out of 30 of the world's wealthiest nations as defined by the Organisation for Economic Co-operation and Development (OECD).
Only 17 per cent of Canadian families have access to regulated child care. Canada ranked last among 25 wealthy, developed nations in meeting various early childhood development objectives.
Canada is amongst the lowest in its coverage of total health-care costs. Medicare covers only 70 per cent of total health-care costs, giving Canada a rank of 22nd of 30 OECD nations for public coverage of health-care costs.
Canada is among the nations with the greatest gap between men's and women's earnings. Canada ranks 19th of 22 OECD nations in reducing the earnings gap between men and women.
Over 40 per cent of Canadians with disabilities are not in the labour force, forcing many of them to rely upon social assistance benefits. Canada ranks 27th of 29 in public spending on disability-related issues.

Raphael, who teaches in 91��ɫ's Faculty of Health, has researched and written widely on these issues. His recent publications include , , and Health Promotion and Quality of Life in Canada: Essential Readings.

Mikkonen is a vice-president of the European Anti-Poverty Network (EAPN) Finland and a member of the executive committee of the EAPN. He has held positions in decision-making bodies at the University of Helsinki, the Finnish Student Health Services and the Finnish Youth Co-operation Allianssi, an umbrella organization for more than 100 Finnish youth non-governmental organizations.

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

The post Researchers' report details how living conditions determine health of Canadians appeared first on Research & Innovation.

Health Policy & Management professors address health, health care and illness prevention in Canada & US

fmaquito — Wed, 21 Apr 2010 08:00:00 +0000

Four years after it was first published, a second edition of the book has just been published, providing a fresh perspective on health, health care and illness.

Co-edited by 91��ɫ School of Health Policy & Management Professors and , along with University of Toronto health studies Professor Toba Bryant, the second edition of Staying Alive (Canadian Scholars’ Press Inc.) has been thoroughly updated.

It features a new chapter on research methodology; expanded discussions of inequality, women’s health, public health and public policy; more material on First Nations health; and a new discussion of the historical development of the Canadian medicare system.

"The first edition sold really well and there isn’t another source out there that covers the same material in one book," says Rioux, who also directs the 91��ɫ Institute for Health Research. "A second edition was needed."

The collection also includes chapters on pharmaceutical policy, social class, race, gender and care, as well as the social construction of illness and disability. In addition, it looks at approaches to promoting population health that include insights into the impact of economic forces such as globalization and privatization.

Left: Dennis Raphael

“Concerns about health and the health-care system have reached a fever pitch in Canada in recent years,” write the editors. “The public is subjected to a daily onslaught of media stories about the causes and treatment of disease and the threats to the sustainability of the Canadian health-care system.”

The book strives to bring together isolated yet important perspectives in identifying key issues in health, illness and health care, relating them to current policy environments as a means of identifying the complex origins of the problems identified and contributing in a meaningful way to their solution.

It focuses on the Canadian scene with relevant comparisons to the United States and other countries and is organized in four parts. The first part provides an overview and critical review of four major health paradigms – the epidemiological, sociological, political economy and human rights perspectives – and a new chapter on research paradigms and methodologies.

Right: Toba Bryant

The second part explores the emerging field of the social determinants of health with a focus on social class, gender and race as indicators of differential access to the economic and social resources available within a society.

In the third part, a comparative history of the Canadian health-care system is provided, along with an overview of current attempts at reform and a detailed analysis of the effects upon the system and its participants of recent trends toward privatization.

Left: Marcia Rioux

The final part considers critical issues in health and health care that illustrate some of the key themes of the volume, including gender and its interaction with health and health care; the construction of illness and disability; health policy through the lens of pharmaceutical policy and the health-care system; and public health concerns of varying national jurisdictions.

Staying Alive is expected to be of interest to a wide range of readers in the fields of health studies, nursing and social policy. In addition to traditional health sciences and sociological approaches, the book provides human rights and political economy perspectives on health, focusing on Canada and the United States within an international context.

For more information, visit the Web site.

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

The post Health Policy & Management professors address health, health care and illness prevention in Canada & US appeared first on Research & Innovation.