1Health care in Canada: What makes us sick?
Throughout the winter and spring o 2013, the CanadianMedical Association (CMA) conducted wide-ranging con-sultations to gather input on Canadians’ views on the socialdeterminants o health. Public town hall meetings were heldin Winnipeg, Hamilton, Charlottetown, Calgary, Montréaland St. John’s and were accompanied by an online consulta-tion at www.healthcaretransormation.ca.The process was ramed around our questions aimed atdetermining what actors beyond the health care system inu-ence health, what initiatives oset the negative impact o thesedeterminants, what governments and health care providersshould be doing to address these social determinants, and how equal access or all to the health care system can be achieved.In every phase o the consultation, our main social deter-minants o health were identifed by participants:
•income•housing •nutritionandfoodsecurity •earlychildhooddevelopment
Several other social determinants o health were men-tioned, such as culture, the environment, education andhealth literacy.Participants stressed that society, governments and healthcare providers all have an obligation to address such problemsas poverty, inadequate housing and nutrition.Because the health o indigenous peoples in Canada wasseen as being particularly inuenced by the social determi-nants o health, the CMA held a town hall meeting to addressthe challenges acing Aboriginal people and communities.Several themes rom the town hall meetings were summa-rized by CMA President Dr. Anna Reid:
-ence early childhood neurologic development.
and underlie many o the social determinants o health.
there is a clear role or citizens, physicians and communi-ties to help deal with the problems.
viewed as investments.
will and leadership to address social inequities.
and can have a positive impact on health outcomes.
must be addressed to improve health outcomes or thesecommunities.
existing spending is important.Based on the input received, clear areas o action haveemerged :
That the ederal, provincial and ter-ritorial governments give top priority to developing an actionplan to eliminate poverty in Canada.
That the guaranteed annual incomeapproach to alleviating poverty be evaluated and tested
That the ederal, provincial and ter-ritorial governments develop strategies to ensure access toaordable housing or low-and middle-income Canadians.
developed by the Mental Health Commission o Canada toprovide housing or people with chronic conditions caus-ing homelessness should be continued and expanded to all
That a national ood security programbe established to ensure equitable access to sae and nutri-tious ood or all Canadians regardless o neighbourhood orincome.
That investments in early childhooddevelopment including education programs and parental sup-ports be a priority or all levels o government.