Addressing the non-medical determinants of health: a survey of Canada's health regions.
BACKGROUND
The Canadian health system is undergoing reform. Over the past decade a prominent trend has been creation of health regions. This structural shift is concurrent with a greater emphasis on population health and the broad determinants of health. In parallel, there is a movement toward more intersectoral collaboration (i.e., collaboration between diverse segments of the health system, and between the health system and other sectors of society). The purpose of this exploratory study is to determine the self-reported level of internal action (within regional health authorities) and intersectoral collaboration around 10 determinants of health by regional health authorities across Canada.


METHODS
From September 2003 to February 2004, we undertook a survey of regional health authorities in Canadian provinces (N = 69). Using SPSS 12.0, we generated frequencies for the self-reported level of internal and intersectoral action for each determinant. Other analyses were done to compare rural/suburban and urban regions, and to compare Western, Central and Eastern Canada.


RESULTS
Of the 10 determinants of health surveyed, child development and personal health practices were self-reported by the majority of health regions to receive greatest attention, both internally and through intersectoral activities. Culture, gender and employment/working conditions received least attention in most regions.


CONCLUSIONS
The exploratory survey results give us the first Canadian snapshot of health regions' activities in relation to the broad range of non-medical determinants of health. They provide a starting data set for baselining future progress, and for beginning deeper analyses of specific areas of action and intersectoral collaboration.
Frankish
C James
CJ
Institute of Health Promotion Research, University of British Columbia, Vancouver. Frankish@interchange.ubc.ca
Moulton
Glen E
GE
Quantz
Darryl
D
Carson
Arlene J
AJ
Casebeer
Ann L
AL
Eyles
John D
JD
Labonte
Ronald
R
Evoy
Brian E
BE
D002170:Canada; D003299:Cooperative Behavior; D018166:Health Care Reform / Q000458:organization & administration*; D006292:Health Priorities / Q000458:organization & administration; D006305:Health Status Indicators; D006801:Humans; D007373:Interinstitutional Relations; D011635:Public Health Administration; D012040:Regional Health Planning / Q000458:organization & administration*; D012423:Rural Health; D012959:Socioeconomic Factors; D012962:Sociology, Medical; D014504:Urban Health