David Phipps (ResearchImpact, York) wrote the following guest blog post for “Health Policies” about a new initiative with UWYR that is focused on community solutions for community health challenges arising from the social determinants of health.
Health isn’t a problem. Not being healthy is a wicked problem. Wicked problems are persistent social problems characterized (among other things) by:
- Lack of clarity on all stakeholders associated with the problem
- Lack of clarity on the causes of the problems
- Lack of clarity on end points and outcomes
- Interventions change the nature of the wicked problem challenging evaluation
Social determinants of health (SDOH) are wicked problems.
There is an increasing amount of attention paid to SDOH at the international, national and local levels:
- International: The World Health Organization recently released the technical paper for the World Conference on Social Determinants of Health to be held in Rio de Janeiro in October 2011.
- National: National Collaborating Centre for Determinants of Health (NCCDH) is one of six NCCs funded by the Public Health Agency of Canada (PHAC). In 2010 it released an environmental scan of the role of public health agencies in supporting policy responses to social determinants of health in Canada.
- Local: On June 22 York Region’s Human Services Planning Board release their report, Making Ends Meet which identifies poverty and income insecurity as the single human service priority for York Region. Health indicators and outcomes are included in the planning.
But how do you tackle such large, wicked problems. According to WHO Commission on Social Determinants of Health, all you need to do is:
- Improve living conditions
- Tackle inequitable distribution of power, money and resources
- Measure and understand the problem and assess the impact of action.
I’ll get right on that. I’ll also get right on solving the upstream political issues underlying SDOH that were pointed out in a previous Healthy Policies blog.
NOT (and therein lies the problem – where do you start with a wicked problem like SDOH?) Continue reading ‘Small steps towards a big problem: Addressing the social determinants of health at the community level’