How to Think about Social Determinants of Health: Revitalizing the Agenda in Canada

Abstract

Five years after the release of the report of the WHO Commission on Social Determinants of Health, limited progress has been made in advancing its agenda of reducing health inequity by way of action on the social determinants of health, despite the added urgency introduced by the post‐2008 financial crisis. With a focus on Canada but drawing on developments and issues elsewhere, we identify three directions for revitalizing the agenda: challenging “lifestyle drift”; thinking differently about questions of how much evidence is enough to justify action (the standard of proof); and focusing on policy priorities, with the recognition that public finance is a public health issue. We conclude with observations about the need to break down the “silos” that impede governmental action on social determinants of health, and to build public support for such action more effectively than has been the case to date.