Raphael Dennis, Sayani Ambreen
Graduate Program in Health Policy and Equity, York University, Toronto, Canada.
Health Promot Int. 2019 Apr 1;34(2):215-226. doi: 10.1093/heapro/dax073.
In Canada's liberal welfare state the public is given little exposure by governmental authorities to the importance of promoting health equity through public policy action on the social determinants of health (SDoH). Not surprisingly, Canada lags in implementing health equity-enhancing public policy. In Ontario, Canada's most populous province, a local public health unit (PHU) took on the task of promoting health equity by developing the video animation Let's Start a Conversation about Health and Not Talk about Health Care at All. In the wake of this work, an additional 17 local PHUs (of 36) adapted it for local use. By placing these activities within Nutbeam's and de Leeuw's concepts of critical health literacy as an essential component of health promotion, we examine how these PHUs came to adopt the video, their intended uses, and supports and barriers encountered. These efforts by local PHUs to promote health equity through action on the SDoH have implications for those in jurisdictions where State attention to these issues is lacking.
在加拿大的自由福利国家，政府当局很少向公众宣传通过针对健康的社会决定因素（SDoH）采取公共政策行动来促进健康公平的重要性。毫不奇怪，加拿大在实施增进健康公平的公共政策方面滞后。在加拿大人口最多的安大略省，一个地方公共卫生部门（PHU）承担了通过制作视频动画《让我们开始聊聊健康，而非仅仅谈论医疗保健》来促进健康公平的任务。这项工作开展之后，另外17个地方公共卫生部门（总共36个）对其进行了改编以供当地使用。通过将这些活动置于努特贝姆和德利乌关于批判性健康素养是健康促进的重要组成部分的概念框架内，我们研究了这些公共卫生部门是如何采用该视频的、其预期用途以及所遇到的支持和障碍。地方公共卫生部门通过针对健康的社会决定因素采取行动来促进健康公平的这些努力，对那些所在司法管辖区缺乏国家对这些问题关注的地区具有启示意义。
