A History of the Social Determinants of Health in Canada through the Lens of the Canadian Public Health Association, 1910-2010: Implications for Present and Future Population Health in Canada
Bibliographic record
Abstract
The 2008 final report of the WHO’s Commission on Social Determinants of Health (SDOH) marked a watershed in the history of the SDOH for bringing together decades of evidence and theory on the social causes of illness from the diverse health research landscape. Yet, a rich history predates this and other contributions (e.g., 1974 Lalonde Report) that are widely credited as the start of the SDOH approach. This history is revealed through casting the contemporary interpretive lens of the SDOH onto the past. I gained a nuanced understanding of the emergence and evolution of the SDOH in Canada by analyzing the archives of the Canadian Public Health Association (CPHA) from 1910 to 2010. I applied a social history and critical public health perspective while exploring this data using methods of thematic content analysis. To situate my findings with relevance to the contemporary landscape of population and public health (PPH), I complemented my analysis of archival sources with that of published and grey SDOH literature, print news articles, and oral history interviews with PPH leaders. My findings show that as a way of thinking, the SDOH approach is complex and diffuse. This, coupled with the inherently political nature of the SDOH, presents challenges in terms of communicating key messages of the SDOH to decision-makers and the public. Additionally, the history of the SDOH is non-linear and changes alongside social, economic, and political events. Economic recession and growth, for example, at times brought more and less urgency to act on the SDOH within the Canadian PPH community. However, despite that ebb and flow, the foundations of health equity and social justice have remained firm throughout the history of the SDOH. These foundations, combined with the growth and increasing disciplinary coherence of PPH, suggest that action on the SDOH will remain a core commitment of PPH.
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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 | 0.009 | 0.016 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.014 | 0.032 |
| Science and technology studies | 0.043 | 0.042 |
| Scholarly communication | 0.024 | 0.007 |
| Open science | 0.003 | 0.007 |
| Research integrity | 0.003 | 0.009 |
| Insufficient payload (model declined to judge) | 0.006 | 0.000 |
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".