I point us to a growing body of literature on how social and economic factors influence both the individual’s health as well as the health status of a population. It is the inherent power that controls resources, the physical environment and to shape health policy. Policies relating to social equality are poor cousins to efficiency and reforms that are part of a neoliberal and neoconservative agenda. This understanding of citizenship makes us recognise justice or injustice not only as moral reasoning but as the experiences of social relationships, transnational organisations, and the power of the state. Different patterns of inequality are present in our society with varying degrees of concerns from civil society, those effected or the state. Class, gender and culture are not the only determinants of power. Race also regulates relationships. In understanding health, social status indicators point to disparities that influence the human body. However, change is slow in rectifying the inequalities that lead to illness and early mortality for some in our society. Every level of government ‘throws’ millions of dollars at various race problems or health crisis like SARS when it occurs in our society with little accountability or an actual action plan. When a crisis takes place in, impoverish neighbourhoods in Canada, the scrutiny of media and the public forces a formal reaction usually tied to funds being available from various levels of government to help solve the crisis without valid input from those affected. The Canadian Press (June 16, 2007) reported that regarding prescription cost there is a widening gap between the wealthy and the have-nots. If we place this as an issue, relating it to justice, it points us to the assumption that everyone in society should have economic resources to meet their basic needs. However, because of structural inequalities, the poor are getting poorer.
Understanding the social determinants of health shows us how to think critically about a better future and to look at the systemic problems and the structural problems that currently exists. Economically, powerful interest groups lobby governments and policies are made in their interest. As we examine the allocation of resources in Canada, we need to consider the lack of power of those groups at the bottom of our social hierarchy. One group furthers their interest by lobbying politicians’ while the other group hears political rhetoric that lacks accountability. Health Canada maintains information on the health of our population. Together with other studies (such as Kawachi et. al., 1997, 1999; Siegler 2003; Rapheal 2004) as well as the latest study on the homeless (Vincent, 2006), we have more than enough data to know if basic societal standards are met. Like all policy issues, we need action, not more studies.
Social justice is achieved when a baby, no matter who takes herhim home, has the same chances in life as the next infant. To a great part, illness, death, health and wellbeing are socially produced and are intertwined with competition for resources. We know from the Toronto Star that the Homeless census found 5,052 individuals in Toronto on the streets. One of the study’s disturbing findings is that the aboriginal community is overrepresented among the homeless. Aboriginals account for about 1 percent of Toronto’s population but comprise 26 percent of the homeless living outdoors. As well, they were also homeless longer, which is five years compared to about three years for the homeless population as a whole. (Vincent, Jun. 24, 2006). I argue the social determinants of health are an effective roadmap to recognise and identify social injustice within our society. When we review this roadmap, we find as in a society that race and racism are left outside the current framework and like society the dominant group controls what should be considered as important within this area of research. This attitude around race and racism leads to a lack of policy initiatives and resources in the field of race and health.
Rapheal, Dennis (2004) “Social Determinants of Health: Canadian Perspectives.” Toronto. Canadian Scholars’ Press Inc.
Vincent, Donovan. (2006) “Homeless Census finds 5, 052 homeless.” The Toronto Star Jun. 24. http://www.thestar.com