Raphael Dennis
School of Health Policy and Management, York University, Canada.
Promot Educ. 2008 Sep;15(3):15-20. doi: 10.1177/1025382308095650.
International interest in the social determinants of health and their public policy antecedents is increasing. Despite evidence that as compared to other wealthy nations Canada presents a mediocre population health profile and public policy environments increasingly less supportive of health, the Canadian public health gaze is firmly - and narrowly - focused on lifestyle issues of diet, physical activity and tobacco use. Much of this has to do with Canada being identified as being driven by a liberal political economy, a situation shared with a cluster of other developed nations. Reasons for Canada's neglect of structural and public policy issues are explored and ways by which public health workers in Canada and elsewhere can help to shift policymakers and the general public's understandings of the determinants of health are outlined.
国际上对健康的社会决定因素及其公共政策前身的关注日益增加。尽管有证据表明,与其他富裕国家相比,加拿大的人口健康状况平平,公共政策环境对健康的支持也越来越少,但加拿大公共卫生的关注点却坚定且狭隘地集中在饮食、体育活动和烟草使用等生活方式问题上。这在很大程度上是因为加拿大被认为是由自由政治经济驱动的,其他一些发达国家也存在这种情况。本文探讨了加拿大忽视结构性和公共政策问题的原因,并概述了加拿大和其他地方的公共卫生工作者可以帮助改变政策制定者和公众对健康决定因素理解的方式。