Learn more about the foundations
- The Social Determinants of Health
- Health Equity
- Health Ecosystem
- Social Prescribing
The Social Determinants of Health
Health isn't simply a matter of our genetics or our lifestyle. It's shaped by our experiences and the environments we live, learn, work and play in.
The social determinants of health are a broad range of personal, social, economic and environmental factors that determine individual and population health. These determinants include things like our childhood experiences, access to social supports, ethnic backgrounds, gender, genetics and physical environment. Discrimination, racism and historical trauma are also important social determinants of health for many Albertans, creating further barriers to accessing health care.
Social determinants of health contribute to about 50 per cent of our overall health and well-being, while healthcare is only responsible for around 25 per cent!
Income is one of the most important factors.
The COVID-19 pandemic continues to shed new light on the complex ways that the social determinants of health influence health outcomes.
- What determines health?
Government of Canada
- Apple Magazine - AHS Social Determinants of Health
Health equity is the fair and respectful way we treat all people, while at the same time striving to identify and eliminate barriers that prevent the full participation of some groups. Health equity is created when individuals have the fair opportunity to reach their fullest health potential. Achieving health equity requires reducing unnecessary and avoidable differences that are unfair and unjust. Many causes of health inequities can be related to social and environmental factors such as:
- social status,
- and physical environment. Health Equity | Public Health Ontario
82 per cent of health and community leaders in Alberta agreed that there can be no progress on health care quality without progress on health equity Health Equity: Prioritization, Perception, and Progress (2021) | IHI - Institute for Healthcare Improvement
A healthcare system can be imagined as an ecosystem with patients, families, providers and organizations all coexisting and working together to create conditions that are beneficial for all. The integrated, high-performing, complex Health Ecosystem is constantly evolving to reflect changing environmental conditions, demographics, emerging technology and cultural norms.
"Social prescribing is a means of connecting patients to a range of non-clinical services in the community to improve their health and well-being. It builds on the evidence that addressing social determinants of health such as socioeconomic status, social inclusion, housing, and education is key to improving health outcomes.” (WHO, 2022)
What determines our health? Although access to medical care is important to helping keep us healthy, only 20-30% of our health is determined by the medical care we receive. 70-80% of our health is determined by social factors, the “social determinants of health”, which include safe and affordable housing, food security, transportation, social connectedness, a sense of purpose in life, a stable income, and others. Consider someone who cannot afford their mediations or someone who is isolated and has no one to help them when they are sick. Medical care cannot be effective without supportive social factors. Medical wellness and social wellness are inseparable.
In Alberta, we are beginning to consider the role of social factors more formally in peoples’ health. When people visit their primary care doctor or team, exploring their social situation with questions like “Do you ever have trouble making ends meet towards the end of the month?” may be critical to improving health. If people indicate they have challenges, they may be referred to other supportive services either directly or through 211 or a community health navigator. The navigator may will carry out a more in-depth assessment to find out what a person’s social needs are, and then link them with the appropriate community agency, either government or volunteer-based, which can help them address their needs. Importantly, the navigator will check back to make sure that the person’s needs have or are being met. This whole process is known as “social prescribing”.
Although social prescribing is just being introduced in Alberta, it has been in place in some jurisdictions, such as the United Kingdom, for several years. In these cases, social prescribing is proving to have a beneficial impact on peoples’ health and wellness, is leading to lower health system costs, and is enabling health care providers to better meet the needs of their patients thereby reducing provider stresses. With continued expansion of social prescribing in Alberta, we are hopeful to soon achieve these benefits as well.
- Hood CM, Gennuso KP, Swain GR, Catlin BB. County Health Rankings: Relationships between Determinant Factors and Health Outcomes. Am J Prev Med. 2016;50(2):129-135. doi:10.1016/J.AMEPRE.2015.08.024
- Buck D, Ewbank L. What is social prescribing? The King’s Fund. Published 2020. Accessed June 24, 2022. https://www.kingsfund.org.uk/publications/social-prescribing
- Inaugural Social Prescribing Network Conference. Report of the Annual Social Prescribing Network Conference.; 2016. Accessed June 24, 2022. http://www.lowcommission.org.uk/dyn/1435582011755/ASA-report_Web.pdf
- Magnan S. Social Determinants of Health 101 for Health Care: Five Plus Five. NAM Perspect. 2017;7(10). doi:10.31478/201710c
- Mulligan K, Bhatti S, Rayner J, Hsiung S. Social Prescribing: Creating Pathways Towards Better Health and Wellness. J Am Geriatr Soc. 2020;68(2):426-428. doi:10.1111/JGS.16249
- Nowak DA, Mulligan K. Social prescribing. Can Fam Physician. 2021;67(2):88-91. doi:10.46747/cfp.670288
- NHS. Personalised Care Social prescribing and community-based support Summary guide. Published 2020. Accessed June 23, 2022. https://www.england.nhs.uk/wp-content/uploads/2020/06/social-prescribing-summary-guide-updated-june-20.pdf
- Ontario Ministry of Health, Care and LT. CONNECTED COMMUNITIES Healthier Together.; 2017.
- World Health Organization Regional Pacific O for the W. A Toolkit on How to Implement Social Prescribing.; 2022. Accessed July 8, 2022. https://www.who.int/publications/i/item/9789290619765