Social determinants of health and health inequalities 

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Social and economic influences on health

Many factors have an influence on health. In addition to our individual genetics and lifestyle choices, where we are born, grow, live, work and age also have an important influence on our health.

Determinants of health are the broad range of personal, social, economic and environmental factors that determine individual and population health. The main determinants of health include:

  1. Income and social status
  2. Employment and working conditions
  3. Education and literacy
  4. Childhood experiences
  5. Physical environments
  6. Social supports and coping skills
  7. Healthy behaviours
  8. Access to health services
  9. Biology and genetic endowment
  10. Gender
  11. Culture
  12. Race / Racism

Social determinants of health refer to a specific group of social and economic factors within the broader determinants of health. These relate to an individual's place in society, such as income, education or employment. Experiences of discrimination, racism and historical trauma are important social determinants of health for certain groups such as Indigenous Peoples, LGBTQ and Black Canadians.

Health inequalities in Canada

Canada is one of the healthiest countries in the world. However, some Canadians are healthier and have more opportunities to lead a healthy life.

Differences in the health status of individuals and groups are called health inequalities. These differences can be due to your genes and the choices you make. For example, whether you exercise or drink alcohol. However, the social determinants of health can also have an important influence on health. For example, Canadians with higher incomes are often healthier than those with lower incomes.

Health inequity refers to health inequalities that are unfair or unjust and modifiable. For example, Canadians who live in remote or northern regions do not have the same access to nutritious foods such as fruits and vegetables as other Canadians.

Health equity is the absence of unfair systems and policies that cause health inequalities. Health equity seeks to reduce inequalities and to increase access to opportunities and conditions conducive to health for all.

Supporting the reduction of health inequalities

Reducing health inequalities means helping to give everyone the same opportunities to be healthy, no matter who they are or where they live. We are working in a number of ways to reduce health inequalities and address the social determinants of health.

  1. Strengthening the evidence base to inform decision-making
    • The Health Inequalities Data Tool contains a large set of data on health inequalities in Canada by subgroups of the Canadian population, including by social, economic and demographic factors. For example, the size and impacts of health inequalities are available by Indigenous Peoples, Black Canadians, immigrants or Canadians living in rural/remote or urban settings. It was created by the Public Health Agency of Canada and the Pan-Canadian Public Health Network, in collaboration with Statistics Canada, and the Canadian Institute for Health Information.
    • The Key Health Inequalities in Canada: A National Portrait report discusses important health inequalities in Canada. It was developed by the Public Health Agency of Canada and the Pan-Canadian Public Health Network in collaboration with Statistics Canada, the Canadian Institute for Health Information, and the First Nations Information Governance Centre.
    • The How to integrate intersectionality theory in quantitative health equity analysis? A rapid review and checklist of promising practices report provides a summary and checklist of 36 promising practices to integrate intersectionality theory meaningfully into health inequality analyses. The "Strengthening the Integration of Intersectionality Theory in Health Inequality Analysis" (SIITHIA) checklist is proposed to help guide future analyses by the Pan-Canadian Health Inequalities Reporting Initiative. The checklist is also a tool for health researchers and surveillance initiatives that are interested in promoting health equity and integrating intersectionality theory into practice.
    • The Monitoring changes in health inequalities through time: A scan of international initiatives and rapid review of scientific literature report provides a summary of over 20 promising practices to apply when seeking to monitor changes in health inequalities over time. These were identified following a literature review of 14 Canadian studies and a scan of international health inequality monitoring initiatives. Recommendations for future Pan-Canadian Health Inequalities Reporting Initiative (HIRI) analyses of changes in health inequalities over time are shared at the outset of the report. These recommendations will be useful for those who are interested in integrating a temporal component to their health or health inequality analyses.
    • Social determinants and inequities in health for Black Canadians: A Snapshot reports national data on inequalities in health outcomes and determinants of health for Black Canadians, and highlights how Anti-Black racism and systemic discrimination are key drivers of health and social inequities faced by diverse Black Canadian communities.
    • Data on Indigenous children, and health and development in the early years supports the design of effective early childhood development programs and interventions. These resources were developed by the Canadian Institute of Child Health in partnership with the Canadian Council on Social Determinants of Health and the Public Health Agency of Canada.
  2. Engaging beyond the health sector

    The Public Health Agency of Canada established the Canadian Council on Social Determinants of Health to work with leaders from different sectors on the social determinants of health and improve health equity. The Council has produced a number of resources and tools, for example:

  3. Sharing knowledge of action across Canada

    Under the Rio Political Declaration on Social Determinants of Health in 2012, Canada and other member states pledged to take steps to improve health equity. We have documented examples of actions across Canada in these areas as part of the following reports:

Funding Opportunities

Multisectoral action fact sheets

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