Bibliographic record
Abstract
Canada provides an excellent example of how political and economic forces can trump the best intentions of health researchers and workers attempting to promote health equity. While Canadian contributions to concepts of health equity have been so extensive as to provide Canada with a reputation as a 'health promotion powerhouse,' in reality, Canadian action on improving health equity by addressing the social determinants of health has been profoundly lacking. Health inequities in Canada are widespread and manifest in numerous indicators of health such as life expectancy, infant mortality, disease incidence and mortality, and injuries at every stage of the life course. In addition, Canadian public policy has served to weaken the quality of the social determinants of health to which Canadians are exposed, bidding poorly for the future. In this article I present the reasons why this may be the case and the means for reversing these trends. Introduction Canada provides an excellent example of how political and economic forces can trump the best intentions of health researchers and workers attempting to promote health equity. It has been noted that the contributions of Canadians to the concepts of health promotion1 and population health2 have been so extensive as to provide Canada with a reputation as a 'health promotion powerhouse' (Raphael 2008b). The number of Canadian governmental and public health association policy statements, reports, and documents detailing the importance of promoting health equity is remarkable. In Canada, discussion and report writing on these issues continues at a hectic pace (CPHA 2009; Butler-Jones 2008; Canadian Senate Subcommittee on Population Health 2009; PHAC 2007). Part and parcel of these health promotion and population health concepts is the importance of reducing health inequities. Reducing health inequities requires action on the primary influences upon health, that is, the living circumstances to which individuals are exposed (Raphael 2008d). In the health field, these circumstances have come to be called the social determinants of health and include income and its distribution, early child development, education, employment security and working conditions, food and housing, health care, and social exclusion, among others. Promoting health equity requires improving the quality of the social determinants of health to which individuals are exposed and making the distribution of these social determinants of health more equitable. The key to improving health equity therefore is reducing social inequities.3 The quality of these social determinants is itself shaped by public policies implemented by governments. As one illustration of the impact of public policy, wealthy developed nations differ profoundly in their commitments to providing citizens with sufficient income to attain health. In the Scandinavian nations the distribution of income through wages and benefits is such that family poverty has been virtually eliminated (Innocenti Research Centre 2007). This is much less so in developed nations that are English speaking. A similar situation is seen for the promotion of early child development through the universal provision of free or low cost high quality childcare. The Scandinavian nations provide such care; the English-speaking nations do not (Innocenti Research Centre 2008). In reality, Canadian action on improving health equity by addressing the social determinants of health has been profoundly lacking. It has been noted by the Canadian Senate's Subcommittee on Population Health, the authoritative Canadian Population Health Initiative, and the business oriented Conference Board of Canada, among others, that Canada lags well behind other wealthy developed nations in addressing the social determinants of health (Raphael 2010). This is also the conclusion of numerous academic researchers who have examined the current state of Canadian health-related public policy activity. …
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.009 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.004 |
| Science and technology studies | 0.013 | 0.004 |
| Scholarly communication | 0.008 | 0.002 |
| Open science | 0.002 | 0.005 |
| Research integrity | 0.004 | 0.005 |
| Insufficient payload (model declined to judge) | 0.042 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".