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Social determinants of health being ignored by mainstream media, despite evidence of its importance

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By Roderick Benns

When Dr. Dennis Raphael first became aware of the proven connection between adverse health effects and social inequality, he assumed the media would be all over it.

Richard Wilkinson’s ‘Unhealthy Societies: The Afflictions of Inequality’ had just been released in 1996 and it shone a spotlight on the unfavourable health consequences of “neo-liberal restructuring of the economy in the UK,” according to Raphael. As Raphael writes in his paper ‘Mainstream Media and the Social Determinants of Health in Canada: Is it Time to Call it a Day?’ the publication of Wilkinson’s book “was especially timely as Canada had just entered a period of welfare state retrenchment which led to significant reductions in governmental expenditures…”

Raphael writes that, “as a naive newcomer to the health promotion and health policy scene in the mid-1990s, I assumed that once the connections were made…the mainstream media would jump on this story.”

He was wrong. The professor found that despite his efforts to show the empirical links, in a 15-year-period his success could have been counted on with only one hand. This limited exposure was thanks to a few columnists and their attempts to write about it. The reasons were complex and varied for the work being largely ignored, but some of Raphael’s hypotheses include that:

  • reporters think just like everyone else in society
  • reporters are expected to tow the accepted line
  • emphasizing biomedical and behavioral approaches to health is profitable

“It’s an uphill battle,” he tells Leaders and Legacies. When asked for asset-based examples of instances where the social determinants of health are being considered, Raphael points to agencies and some public health units.

“It’s much more apparent and well known at the agency level and public health level now. But it still hasn’t penetrated at all into the media, or into any public policy agenda of any province,” says Raphael.

The professor says the federal NDP now has a page on the social determinants of health up on their website.

In even better news, Raphael points to Ryan Meili, a Saskatoon physician who ran for the leadership of the Saskatchewan NDP twice, losing only by 44 votes the second time in 2013.

“He organized his whole campaign around the social determinants of health.”

As well, Meili wrote a book called ‘A Healthy Society’ and he created Upstream, a social-media-friendly institute designed to put the social determinants of health on the public policy agenda.

As for Raphael and his attempt to get the word out, he and vice-president of the European Anti-Poverty Network Finland, Juha Mikkonen, have written ‘Social Determinants of Health: The Canadian Facts’ and set up a website to support their findings.

The following is the summary of The Canadian Facts website:

The primary factors that shape the health of Canadians are not medical treatments or lifestyle choices but rather the living conditions they experience. These conditions have come to be known as the social determinants of health. This information – based on decades of research and hundreds of studies in Canada and elsewhere – is unfamiliar to most Canadians. Canadians are largely unaware that our health is shaped by how income and wealth is distributed, whether or not we are employed and if so, the working conditions we experience.

Our health is also determined by the health and social services we receive, and our ability to obtain quality education, food and housing, among other factors. And contrary to the assumption that Canadians have personal control over these factors, in most cases these living conditions are – for better or worse – imposed upon us by the quality of the communities, housing situations, work settings, health and social service agencies, and educational institutions with which we interact. Improving the health of Canadians requires we think about health and its determinants in a more sophisticated manner than has been the case to date. Social Determinants of Health: The Canadian Facts considers 14 social determinants of health. (See accompanying chart.)


The publication outlines why they are important; how Canada is doing in addressing them; and what can be done to improve their quality. The purpose of the document is to provide promote greater awareness of the social determinants of health and the development and implementation of public policies that improve their quality.

For more information visit The Canadian Facts here.




  1. Dr. Richard Nutter

    Child welfare/ protection is a very important part of social work practice. My experience in child welfare has lead me to believe that most abused and/or neglected children are in families/households that have low SDOH: Low income, poor housing, parents’ low education, parents’ and children’s low early education and care, etc. However, most child welfare/protection case files contain very little SDOH data. I have not found an SDOH protocol designed for child welfare/protection investigations. Race is often recorded because provinces get money from the Federal Government for first nations children (Indians). Is there a robust protocol for collecting SDOH data describing individual families? If there is, please send me a copy.

  2. Roderick Benns

    Dr. Raphael says “it’s a good question.”

    “Mt. Sinai Hospital has begun asking these questions of patients.”


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