This week in the Master of Health Studies program we focused on the determinants of health, how they are defined, how they influence health policies and how they impact health outcomes. As the Government of Canada (2020) states, "the determinants of health are the broad range of personal, social, economic and environmental factors that determine individual and population health."
So how do these determinants influence health outcomes?
In Newfoundland and Labrador we have higher rates of obesity, smoking, and alcohol consumption than most of the country and a slightly lower life expectancy (Canadian Institute for Health Information, 1996-2021). To try to tackle this problem, the Government of Newfoundland and Labrador Department of Health and Community Services (2006) has focused its efforts on promoting 'Wellness Priorities' through its 'Provincial Wellness Plan'. These wellness priorities include improving physical activity and healthy eating, improving access to mental health services, promoting tobacco cessation, improving child development programs, and promoting injury prevention (Government of NL, 2006). Yet one thing that was brought up in our class discussion was whether we are losing sight of the root cause of poor health outcomes by focusing so heavily on personal health practices. For example, if you do not have the income to afford to make healthy dietary choices, to purchase a fitness membership, to see a therapist or counsellor, then the 'wellness priorities' while good in theory, are essentially inapplicable to a portion of the population.
As a community pharmacist, I have observed how access to healthcare, income and social status, and education, specifically health literacy, affect people in their daily lives. I have witnessed people deciding whether they purchase their blood pressure medication or their child's antibiotics, taking more of a prescribed drug because they were not capable of following directions, deciding whether they can see a dietician as they do not have an insurance plan to cover the cost of that service, and the list goes on. If an individual cannot afford, seek out or understand the healthcare services they need, then one would assume they would have poorer health outcomes.
It seems clear to me, based on our class discussion, that income, education and access to health services play a major role in influencing health outcomes. Perhaps attention should be paid to these determinants as well in order to have a larger improvement in health outcomes for the people of Newfoundland and Labrador.
“A health care system - even the best health care system in the world - will be only one of the ingredients that determine whether your life will be long or short, healthy or sick, full of fulfillment, or empty with despair.” (The Honourable Roy Romanow, 2004, as cited in Ontario Trillium Foundation, n.d.)
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References
Canadian Institute for Health Information. (1996-2021). Your health system. Retrieved
October 17, 2021 from yourhealthsystem.cihi.ca/hsp/inbrief?lang=en#!/search/2/C10151
Government of Canada. (2020). Social determinants of health and health inequalities. Retrieved October 18, 2021 from www.canada.ca/en/public-health/services/health-promotion/population-health/what-determines-health.html
Government of Newfoundland and Labrador Department of Health and Community
Services. (2006). Achieving health and wellness: provincial wellness plan for Newfoundland and Labrador. Retrieved October 18, 2021 from www.gov.nl.ca/hcs/files/publications-pdf-provincial-strategies-nlprovincialwellnessplan.pdf
Ontario Trillium Foundation (n.d.). Measuring What matters: how the Canadian index of
wellbeing can improve quality of life in Ontario. Retrieved October 19, 2021 from www.allianceon.org/sites/default/files/measuring-what-matters-web.pdf
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