Concepts of Health and Determinants of Health in Canada

Conceptualizing HealthPage 1

Health concepts have evolved significantly since the 1970s, now heavily influenced by social justice and public health crises like COVID-19. Modern definitions have moved beyond a negative focus (absence of disease) to positive, multidimensional models (physical, mental, social, and spiritual well-being). Theories categorize health as stability, actualization, resource, or unity, with the most widely accepted view defining health as a resource for everyday life rather than an end state.

Historical Approaches to HealthPage 1

Canadian health policy has shifted through three major phases: the medical approach (focused on clinical intervention and treatment), the behavioural approach (emphasized in the 1974 Lalonde Report, focusing on individual lifestyle choices), and the socioenvironmental approach (emphasized in the 1986 Ottawa Charter, focusing on social structures, equity, and the root causes of health disparities).

Social Determinants of HealthPage 2

The social determinants of health represent the conditions in which people live that shape their health status. Critical factors include income and income distribution, education and literacy, employment security, working conditions, early childhood development, food security, physical environment, and social support. These factors are interrelated; for instance, poverty and systemic racism often compound to create significant health inequities for marginalized groups like Indigenous peoples and LGBTQ2 communities.

Inequities and Systemic FactorsPage 3

Health inequities—systemic, avoidable differences in health—are largely driven by societal policies. Indigenous status remains a critical determinant due to the enduring trauma of colonization and residential schools. Gender, race, and experiences of systemic racism are also major drivers of disparities, influencing access to resources and creating chronic stress. Addressing these requires a move toward health equity, focusing on political, economic, and social reforms that dismantle unfair systems.

Individual Health PracticesPage 4

While personal choices regarding physical activity, nutrition, and substance use (including tobacco, vaping, and cannabis) are significant, they are not purely individual decisions. These practices are heavily mediated by social and economic circumstances. Effective health promotion must therefore move beyond simple education to creating environments where healthy choices are accessible and supported by robust social safety nets and equitable public policy.