title: Canadian adolescent perceptions and knowledge about the social determinants of health: an observational study of Kingston, Ontario youth.
abstract: BACKGROUND
  Upstream social determinants of health (SDH) have become widely acknowledged as lying at the root of poor health outcomes in Canada and globally. The Commission on the Social Determinants of Health maintains that educating the public about the SDH is a key step towards population health equity. Little is known about adolescent perceptions of the determinants of health. Curriculum in Ontario is lacking in SDH content, placing a much greater emphasis on individual, lifestyle behaviors, such as diet, physical activity, and safe sex practices. Identifying a gap in SDH knowledge within the adolescent population is required to advocate for health curriculum revision to include SDH material.
  
  
  METHODS
  Student sociodemographic information was obtained through a self-administered questionnaire. Concept mapping exercises were used to determine students' knowledge of the determinants of health and the SDH. Knowledge was approximated by the relative number of SDH concepts present in student maps. Poisson regression analysis was used to determine correlations between sociodemographic characteristics and SDH knowledge.
  
  
  RESULTS
  Concept maps indicated that students attributed their health primarily to physical determinants versus social determinants; 44% of maps contained no SDH content. Statistical analyses indicated that students' SDH knowledge varied by their relative socioeconomic status (SES).
  
  
  CONCLUSIONS
  Findings suggest that 1) there is an SDH knowledge gap in the adolescent population, and 2) an inequity in adolescent SDH knowledge exists across socio-economic factors. Current Ontario health curriculum requires revision to include SDH material, which will require greater communication and collaboration from both educational institutions and health agencies in Canada.
authors: School of Kinesiology and Health Studies, Queen's University, 28 Division Street, Kingston, ON K7L 4M7, Canada. mooresp@queensu.ca.
authors: Kelly E
authors: KE
authors: Kenney
authors: Spencer
authors: S
authors: Moore
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D016497:Adolescent Health Services; D003710:Demography; D005260:Female; D006266:Health Education; D006801:Humans; D008297:Male; D009864:Ontario / Q000453:epidemiology; D012572:School Health Services; D064890:Social Determinants of Health; D011795:Surveys and Questionnaires
references: J Pers Soc Psychol. 2003 Feb;84(2):439-48
references: 12585815
references: Nurs Stand. 2004 Nov 10-16;19(9):33-8
references: 15574052
references: Am J Epidemiol. 2005 Sep 15;162(6):559-68
references: 16093286
references: Qual Health Res. 2010 Sep;20(9):1173-82
references: 20442342
references: Health Promot Int. 2011 Dec;26 Suppl 2:ii194-201
references: 22080074
references: Philos Trans R Soc Lond B Biol Sci. 2002 Aug 29;357(1424):1123-36
references: 12217179
references: Health Policy Educ. 1982 Mar;2(3-4):213-50
references: 10298649
references: J Consult Clin Psychol. 2002 Jun;70(3):828-42
references: 12090386
references: Lancet. 2008 Nov 8;372(9650):1661-9
references: 18994664
references: Trends Neurosci. 2006 Mar;29(3):148-59
references: 16472876
references: CMAJ. 2006 May 9;174(10):1415-20
references: 16682708
references: Annu Rev Public Health. 2006;27:297-322
references: 16533119
references: Int J Health Serv. 2006;36(4):651-77
references: 17175840
references: Health Promot Pract. 2010 May;11(3 Suppl):26S-33S
references: 20488966
references: J Cancer Educ. 2009;24(1):58-64
references: 19259867