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Determinants of Health: A Canadian and Albertan Perspective

While looking for the Canadian determinants of health and more locally for Albertans, I found myself completely overwhelmed. What, indeed, does determine health in my country and province? I had heard about 'social determinants of health' in my past education, but had not considered the broader issue of 'health' overall. When defining what health is, it is not one easy or straightforward thing but a collection of things.

My initial thought, as an easy starting place was to consider Maslow's Hierarchy of Needs. The Hierarchy explains that humans must have basic level needs (food, water, shelter, sleep) in place prior to achieving anything further up the pyramid which includes the Safety and Security stage, of which health is a part. In short, a population must have their basic physiological needs met to function properly and have the capacity to worry about their health (McLeod, 2024). Prior to looking into what Canada or Alberta consider determinants of health we already have a good start. People need food, water and shelter- basic building blocks of life in order to have the capability to achieve anything greater. Imagine my surprise when I looked up the Canadian Determinants of Health to find that basic needs, while perhaps are present in implication, are lacking explicitly (more below). 

Maslow's Hierarchy of Needs (McLeod, 2024)
Maslow's Hierarchy of Needs (McLeod, 2024)

My first stop for gaining an understanding about the Federal Canadian view of social determinants of health was the Government of Canada Website which states that "Determinants of health are the broad range of personal, social, economic and environmental factors that determine individual and population health." (Public Health Agency of Canada, 2024). It goes on to list 12 factors associated with health including:  work, education, income, where we live, social supports we have, the quality of childhood experiences, genetic endowment and the physical environment. Essentially, the hand we have been dealt in life. The list appears to strike a balance between things that individuals can control, to some extent (i.e. healthy behaviour, education, income/ employment), and things that are out of our control (i.e. genetics, gender, race). 


Another National article I came across is National Collaborating Centre for Determinants of Health (2024). This article highlighted the Government of Canada's determinants as well as Maslow's basic needs (see below image).  This framework combines some of the GoC's determinants while ignoring things like culture, race and gender. Instead, it focuses more on basic needs of life. I find that neither is a 'complete' list of determinants of health, but combined together it gives a much more comprehensive picture. 


(National Collaborating Centre for Determinants of Health, 2024)
(National Collaborating Centre for Determinants of Health, 2024)

The Determinants of Health for Albertan's reflects the GoC's framework. It states that the key determinants of health include, "Income and Social Status, Social Support Networks, Education and Literacy, Employment and Working Conditions, Social Environments, Physical Environments, Personal Health Practices and Coping Skills, Healthy Child Development, Biology and Genetic Endowment, Health Services, Gender, Culture." (Alberta Health Services, n.d.).  The Population Health Promotion Program (PHPP) aims to increase overall health of the provincial population. The program links with Provincial Population and Public Health Programs to deliver a wide range of health promotion interventions, including: oral health, injury prevention, tobacco reduction, health equity, poverty reduction, health promotion education, health surveillance, and patient advocacy (Alberta Health Services, n.d.). Alberta has also explicitly mentioned the basic needs of Maslow's hierarchy. The PHPP is one specific program. Anther provincial resource from Alberta Health Services provides this graphic showing the interconnectedness between determinants of health:


(Alberta Health Services, 2024)
(Alberta Health Services, 2024)

This framework is designed to assist community teams to focus on local priorities. The items in the center are factors out of an individuals control, while the rings that move outwards can be changed by the individual if they are supported in accessing the determinants of health. Access to care remains a big priority in Alberta as we have many rural and hard to access communities. (Alberta Health Services, 2024).


The social determinants of health in Canada and Alberta show a lot of cohesion. While it appears the Canadian determinants have more 'social' factors (race, culture) the Alberta determinants make a point of including basic needs (water, housing). I think that within and between the above resources a complete framework can be determined. The goal is overall 'health', which is a funny thing considering the difficulty defining that very term. Access, education, and home/ work life of an individual seem to be the building blocks of an individuals health. If one block is shaky or broken, 'health' will be difficult to achieve. Proper supports and advocacy will be required to assist an individual to be 'well'.



References 


Alberta Health Services. (n.d.). Population health promotion program. Retrieved

from https://www.albertahealthservices.ca/findhealth/service.aspx?

Id=3677#:~:text=The%20Key%20%E2%80%9DDeterminants%20of%20Health%E2%80%9D%20include%3A%20Income%20and,Skills%2C%20Healthy%20Child%20Development%2C%20Biology%20and%20Genetic%20Endowment 


Alberta Health Services. (2024). What determines health? Retrieved


McLeod, S. (2024, January 24). Maslow’s hierarchy of needs. Simply


National Collaborating Centre for Determinants of Health. (2024, December 16). Let's talk:


Public Health Agency of Canada. (2024, July 18). Social determinants of health and health

 
 
 

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