Healthy living initiatives in Ontario and British Columbia should go beyond individual lifestyle and environment-based interventions to challenge structural inequities, authors argue in a recent study. Health policy documents in both provinces suggested working within a social determinants of health framework to influence upstream sources of health inequities such as income, housing and employment. In spite of that, a review of healthy living initiatives suggest that only a very small proportion address economic and social conditions directly.
The study reviewed 120 provincial healthy living initiatives; half were from Ontario and the other half from British Columbia (2006 – 2011). The selected initiatives focused on healthy eating and physical activity as prevention strategies for chronic disease. Only 15 per cent (nine initiatives) in Ontario and 11.5 per cent (seven initiatives) in British Columbia had components that addressed social determinants of health directly.
The authors discuss challenges and options to create initiatives that consider structural change to support greater health equity. Data and programs can be used to advocate for healthy living with a focus on health inequities. The Ontario Nutritious Food Basket protocol is highlighted as an example where boards of health are mandated by Ontario Public Health Standards to calculate annually the cost of basic healthy eating for individuals and families. This data can then serve as evidence for policy and program decision-making (such as income redistribution policies to ensure families have enough money to maintain a healthy diet) and advocacy work for accessible, affordable foods.
The online abstract, “Social determinants of health in Canada: Are healthy living initiatives there yet? A policy analysis” is available through the International Journal for Equity in Health.