Social determinants of health

13 September 2023

Intersectoral Action for Health and Equity in the Context of Budget Cuts

This document is intended to provide relevant information to Canadian public health professionals and administrators, as well as to others who wish to undertake and sustain intersectoral activities fostering health and equity in the context of budget cuts. It outlines challenges, opportunities, and strategies to be considered when implementing or sustaining intersectoral action for health and equity in the context of budget cuts.

It is now well recognized in public health that intersectoral action is a relevant factor in ensuring that the missions of health prevention and promotion are carried out and that complex and multifactorial problems are addressed. In addition to the usual challenges associated with collaboration, actors wishing to implement or sustain intersectoral action are sometimes confronted with a significant issue, namely budget cuts. Because intersectoral action depends on adequate and stable funding and strong government support, periods of fiscal austerity,…

25 April 2022

Perinatal Psychoactive Substance Use Among Indigenous Women: Social Determinants

Because of its impact on the health of families and future generations, psychoactive substance use during the perinatal period is a public health concern for the entire population. Understanding the factors that influence psychoactive substance use among Indigenous women in the perinatal period is essential to targeting prevention and health and wellness promotion strategies for First Nations and Inuit people. This synthesis analyzes the factors that emerge from the scientific literature through the lens of social determinants of health.

  • Strong family ties, social support and connection to community, traditional values and culture emerged as protective factors against psychoactive substance use during the perinatal period for Indigenous women. These factors are associated with the social environment and cultural continuity, which are social determinants of Indigenous health.
  • Difficult living conditions (job insecurity, low education level, and frequent relocat…
17 September 2020

Pan-Canadian meeting on Health in All Policies (HiAP): Québec City, October 9, 2019 - Report

Health in All Policies (HiAP) is an increasingly important approach for systematically addressing the social determinants of health at all levels of government. HiAP refers to “an approach to public policies across sectors that systematically takes into account the health implications of decisions, seeks synergies, and avoids harmful health impacts in order to improve population health and health equity”.1

In Canada, HiAP is on the radar of several governments, organizations and networks. Advocacy for and the momentum of a HiAP approach has been building, drawing attention to the potential impacts of this approach. Yet challenges to implementation exist across jurisdictions, including the use of a shared language, conflict of interest between sectors, and the need to ensure sustainability. Despite a clear interest, there are few spaces to share and learn from various Canadian and international initiatives and thus accelerate the dissemination and adaptation of pro…

21 January 2020

Material and social deprivation index: A summary

In Quebec, the deprivation index was created first and foremost to overcome the lack of socioeconomic data in most administrative databases.

Developing an ecological proxy was the only way to monitor social inequalities related to important health issues such as mortality, hospitalization and the use of health services. The proxy’s main purpose is to assign area-based socioeconomic information to every individual by linking the geography of the census with the one found in the administrative databases. As a result, the index assists in the surveillance of social inequalities in health in Québec and Canada since the end of the 1980s.

While it was shown that the deprivation index underestimates inequalities (Pampalon, Hamel, Gamache, 2009), it is the best alternative in the absence of socioeconomic information.

10 October 2019

At the Intersection of Language Definitions: A Portrait of Linguistic Communities in Québec and Its Territorial Service Networks in 2016

The Integrated Health and Social Services Centres (CISSS) and Integrated University Health and Social Services Centres (CIUSSS) are at the center of the twenty-two territorial service networks (RTS). The RTS are responsible for providing health care and services to their population, which includes minority linguistic communities that may face communicational obstacles.

In this report, the variables "mother tongue", "language spoken at home" and "knowledge of official languages" from the 2016 census, as well as their intersection, were analyzed for the population of Quebec and that of the RTS.

Overall this report confirms the presence of potential linguistic barriers among minority linguistic communities and shows that those communities served by RTS institutions are quite heterogeneous.


  • In 2016, the population of Québec was 78% francophone as defined by mother tongue or 81% as defined by language spoken at home. Anglopho…