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Writer's pictureEmily Gresham

Social Determinants of Health - Focusing on the Early Years


I believe that we as a society need to "Do More" to address the Social Determinants of Health (SDoH) and barriers to health equity in our communities. The Government of Canada defines Determinants of Health as the broad range of personal, social, economic and environmental factors that determine individual and population health” (Government of Canada, 2021). The Government of Canada outlines the following as the key determinants of health:

  • Income and social status

  • Employment and working conditions

  • Education and literacy

  • Childhood experiences/early childhood development

  • Physical environments

  • Social supports and coping skills

  • Healthy behaviours

  • Access to health services

  • Biology and genetic endowment

  • Gender

  • Culture

  • Race / Racism

As the World Health Organization states the social determinants of health “are the conditions in which people are born, grow, work, live, and age” (WHO, 2021). I found a video that discusses the social determinants of health and also introduced a framework outlined by the World Health Organization. Check it out here:


I have learned through discussions with classmates from my #MHST601 course that each of us may have differing opinions of which SDoH is most important, but I think we can all agree and appreciate that health is complex and the SDoH are very much interconnected. In my opinion one of the most influential social determinants of health is early childhood development. The health unit I work for helped develop a common message paper to enable health practitioners to understand the significance of social and emotional development in the early years and how this directly impacts the adult years. Experiences in early childhood play such an important role in shaping our lives. The common message paper states that “The basic architecture of the brain is constructed through an ongoing process that begins before birth and continues into adulthood...Early experiences affect the quality of that architecture by establishing either a sturdy or fragile foundation for all learning, health and behaviour that follow” (Halton Early Years Mental Committee, 2014). Early experiences in life lay the foundation for our entire lives. A fragile foundation can further impact other social determinants of health as we get older, such as income and social status, education, employment, and coping skills to name a few. Ultimately, a solid foundation helps children to flourish and grow up to be healthy adults.

The Canadian Council on Social Determinants of Health (CCSDH) is a group that was first established by the Public Health Agency of Canada back in 2005, back then referred to as the Canadian Reference Group (CRG) on Social Determinants of Health. This group is a network of stakeholders working together to influence variables that may impact our health and well-being. A publication developed by the CCSDH addresses the importance of the early years and states that research shows the environments in which children grow up in, can significantly impact their trajectory in life (CCSDH, 2017). This publication also outlines the impact of socioeconomic status on early childhood development.


The CCSDH states that “socioeconomic, social capital, physical, ecological, and service characteristics of communities influence ECD; in turn, ECD is the most important determinant of health and well-being across life course” (CCSDH, 2017).


I think it is crucial to understand the role of socioeconomic status and the impact that this has on the early years. As the CCSDH describes, people with lower socioeconomic status may be more likely to experience inadequate housing, poor water quality and exposure to air contaminants which can in turn negatively impact health outcomes (CCSDH, 2017). I believe we all have a role to play to ensure that everyone is able to achieve good health outcomes. Perhaps by focusing our efforts on the early years we may be able to better provide services to address barriers and provide supports necessary to achieve better health.

The Government of Ontario is supporting early childhood development through a variety of different services. One being EarlyOn centres that are open to all families of Ontario. These centres provide opportunities for families to connect with one another through different programs. They also offer support from trained professionals, for example Public Health Nurses will attend these centres to provide information on different topics relating to the early years. Another key program that supports optimal child development is the healthy babies healthy children program, which is a program provided by all public health units in Ontario. This home visiting program is designed for families with young children from zero to start of school who may need extra support. This program aims to help children to achieve optimal growth and development and ensure access to support and services necessary.


I watched a video produced by UBC School of Population & Public Health that addresses the social determinants of health and how human beings are especially sensitive to their surroundings in the early years of life. Check it out below:

 

To leave you with a question...What do you think is the most important or influential SDoH & Why?

 

A classmate of mine addressed the important factors of Income & Wealth as well as Education in her blog post. Check it out here: https://jpabillar.wixsite.com/e-portfolio/post/social-determinants-of-health-an-upstream-approach-for-downstream-concerns


References:


Canadian Council on Social Determinants of Health. (2017). Implementing Multi-Sectoral Healthy Child Development Initiatives: Lessons Learned from Community-Based Interventions. http://ccsdh.ca/images/uploads/Implementing_Multi-Sectoral_HCD_Initiatives.pdf


Halton Early Years Mental Health Committee. (2018). Social-Emotional Development in the Early Years: A Common Message Paper. https://ourkidsnetwork.ca/Public/Page/Files/189_EYMH_Common_

Message_Paper_01_20.pdf


UBC School of Population & Public Health. (2017, Jan 13). The Social Determinants of Health. Retrieved from https://www.youtube.com/watch?time_continue=174&v=nTqknri15fQ&feature=emb_title


World Health Organization. (2021). Social Determinants of Health. https://www.who.int/health-topics/social-determinants-of-health#tab=tab_1





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