Canada's Response to WHO Commission on Social Determinants of Health

WHO Commission on Social Determinants of Health (CSDH)

The WHO Commission on Social Determinants of Health was launched in March 2005 to address the problem of growing inequities in health status within and between countries. Over a three year period, the Commission aims to lever policy change by compiling evidence on the science and action on the social determinants of health, widening societal debate on the topic and proposing global and national policies for action.

Sir Michael Marmot of University College, London, chairs the Commission. It has twenty Commissioners representing global and national leaders from political, government, civil society and academic fields as well as from all geographic regions of the world.

The Honourable Monique Bégin has been appointed as Canada's Commissioner.

Commission's Goals

The Commission's main goals are:

• To support policy change in countries by promoting models and practices that effectively address the social determinants of health.
• To support countries in placing health as a shared goal to which many government departments and sectors of society contribute.
• To help build a sustainable global movement for action on health equity and social determinants, linking governments, international organizations, research institutions, civil society and communities.

Improving health through action on the social determinants of health

The key insight underpinning the work of the Commission is that action in the health care sector is only one of the influences on a population's health. The Commission has the broader aim of improving the circumstances in which people live and work. The Commission will work to catalyse change through:

• Organizing knowledge and compiling evidence of successful interventions and policies
• Promoting action through implementation of policies
• Stimulating advocacy and raising political debate
• Supporting leadership through all of the Commission's action components below.

Five Action Components

1. The Knowledge Networks
Nine Knowledge Networks (KNs) will synthesize knowledge on effective interventions, with a focus on low-income countries, and develop recommendations to inform policy, action and leadership. The KN themes are: Early Childhood Development, Globalization, Health Systems, Employment Conditions; Urban Settings; Social Exclusion; Measurement and Evidence; Priority Public Health Conditions and Women and Gender Equity. Two of the KN hubs (early child development and globalization) are located in Canada.

2. Country Action
The Commission's country work will demonstrate how SDH can become a corporate priority of government, permeating policy and planning in various sectors. The Commission is working with countries where there is a commitment to action to address social determinants of health among political leaders, health officials, civil society groups and other stakeholders as well as countries that can support through expertise and tools. The KNs, Commissioners and experts from countries who are champions will be involved at key points of the process to assist in coordinating, synchronizing, and catalyzing learning between countries. Countries, which are officially engaged as global partners include Canada, England, Sweden, Kenya, Chile, Brazil, Iran, Vietnam, Sri Lanka, Kyrgyzstan, Pakistan and Mozambique.

3. Civil Society Engagement
The Commission is reinforcing its outreach to civil society (CS) and is asking CS actors themselves to design strategies for collaboration. These strategies will involve CS in all major components of the Commission, including: action in partner countries; Commission Knowledge Networks; and the activities of the Commissioners. The strategy will also reflect the diversity of CS actors and the specificities of global regions. The CSDH Secretariat is working with civil society organizations acting as facilitators from four global regions which are:

• Africa: Health International Action; Equinet; Health Civil Society Network;
• Asia: Asian Community Health Action Network; People's Health Movement India;
• Eastern Mediterranean: Association for Health and Environmental Development;
• Latin America and Caribbean: Confederation Latin American of Rural Organizations and
• Association of Rural and Indigenous Women; Latin American Association of Social Medicine; Network for Health and Work.

4. WHO Action
A WHO Reference Group will advise senior leadership at WHO on strategic directions, concrete tools, mechanisms and action plans for integrating a social determinants approach into its General Programme of Work, core budget, and leadership.

5. Global Initiatives
The Commission and WHO will lever action across United Nation institutions on equity in health by informing understanding of how the actions of these institutions impact on health and by providing specific policy proposals for improved action on health. Global institutions working on social determinants of health will be consulted and involved in the work of the Commission.

For more information, visit the Commission website: http://www.who.int/social_determinants/en/