Building relational well-being: empowering street-connected young people to transition from precarity to security through youth associations.

Street-connected young people (SCYP) in Tanzania face intersecting challenges, including economic vulnerability, social marginalisation and limited access to supportive networks. This study examines the impact of the Youth Association (YA) model, implemented by Railway Children Africa, and does so through the lens of the relational well-being approach, which emphasises the interplay of material, relational and subjective dimensions of well-being, as well as personal, societal and environmental drivers of well-being. Using a mixed methods design, this study tracked 116 SCYP in Mwanza and Dar es Salaam, Tanzania, through four stages of the YA model.

Defining health through a critical materialist political economy lens.

It has been recognized since antiquity that the organization of society and how it distributes resources are the primary determinants of health. Yet most definitions of health in the academic and practice literatures limit their focus to the individual's experience of health and functional abilities, neglecting the structures and processes of societies in which the individual is embedded. We draw upon developments in the critical health communication and critical materialist political economy of health literatures to provide a definition of health that directs attention to the role that economic and political systems play in either equitably or inequitably distributing the resources necessary for health.

Beyond Empathy to System Change: Four Poems on Health by Bertolt Brecht.

Bertolt Brecht's poem "A Worker's Speech to a Doctor" is frequently cited as a means to raise awareness among health workers of the health effects of living and working conditions. Less cited is his Call to Arms trilogy of poems, which calls for class-based action to transform the capitalist economic system that sickens and kills so many. In this article, we show how "A Worker's Speech to a Doctor," with its plea for empathy for the ill, contrasts with the more activist and often militant tone of the Call to Arms trilogy: "Call to a Sick Communist," "The Sick Communist's Answer to the Comrades," and "Call to the Doctors and Nurses.

1845 or 2023? Friedrich Engels's insights into the health effects of Victorian-era and contemporary Canadian capitalism.

The Condition of the Working Class in England (hereafter, CWCE) by Friedrich Engels is a masterpiece of urban research not only for its explicit descriptions of the living and working conditions of members of the Victorian-era working class and their effects on health but also its insights into the sources of these conditions through a political economy analysis. For Engels, the capitalist economic system, with the support of the state apparatus, prematurely sickened and killed men, women and children in its unrestrained pursuit of profits. Our reading of CWCE in 2023 concludes that Engels identified virtually every social determinant of health now found in contemporary discourse with his insights into how their quality and distribution shape health clearly relevant to present-day Canada.

Resisting the Effects of Neoliberalism on Public Policy Comment on "Implementing Universal and Targeted Policies for Health Equity: Lessons From Australia".

Fisher and colleagues carefully review the extent to which health equity goals of availability, affordability, and acceptability have been achieved in the areas of national broadband network policy and land-use policy, in addition to the more traditional areas of primary healthcare and Indigenous health in Australia. They consider the effectiveness of policies identified as either universal, proportionate-universal, targeted or residualist in these areas. In this commentary we suggest future areas of inquiry that can help inform the findings of their excellent study.

Emerging Themes in Social Determinants of Health Theory and Research.

Since 1996, we have been working to have Canadian governmental authorities implement health-promoting public policy that would improve the quality and equitable distribution of the social determinants of health, with rather little to show for our efforts. In this commentary, we identify seven emerging themes that can help explain our failures and point the way forward.

Does unionization and working under collective agreements promote health?

Health promoters recognize the social determinants of health (SDOH) shape health outcomes yet generally neglect how unionization and collective agreements (CAs) shape these SDOH. This is surprising since extensive evidence indicates unions and CAs influence wages and benefits, job security, working conditions and income inequality, which go on to affect additional SDOH of food and housing security, child development and social exclusion. We argue unions and CAs should be a health promotion focus by examining how they influence the SDOH and health outcomes in wealthy developed nations in four ways.

Desperately seeking reductions in health inequalities in Canada: Polemics and anger mobilization as the way forward?

Progress in reducing health inequalities through public policy action is difficult in nations identified as liberal welfare states. In Canada, as elsewhere, researchers and advocates provide governing authorities with empirical findings on the sources of health inequalities and document the lived experiences of those encountering these adverse health outcomes with the hope of provoking public policy action. However, critical analysis of the societal structures and processes that make improving the sources of health inequalities difficult-the quality and distribution of living and working conditions, that is the social determinants of health-identifies limitations in these approaches.

The reemergence of Engels' concept of social murder in response to growing social and health inequalities.

In 1845, Friedrich Engels identified how the living and working conditions experienced by English workers sent them prematurely to the grave, arguing that those responsible for these conditions -- ruling authorities and the bourgeoisie -- were committing social murder. The concept remained, for the most part, dormant in academic journals through the 1900s. Since 2000, there has been a revival of the social murder concept with its growth especially evident in the UK over the last decade as a result of the Grenfell Tower Fire and the effects of austerity imposed by successive Conservative governments.

A bibliometric analysis of Health Promotion International content regarding unions, unionization and collective agreements.

A recent article brought together the health benefits of unionization and working under collective agreements. It was noted how Canadian health promotion texts, reports and statements made no mention of unionization and working under collective agreements as promoting health. This was seen as a significant omission and reasons for this were considered.

Understanding the Promotion of Health Equity at the Local Level Requires Far More than Quantitative Analyses of Yes-No Survey Data Comment on "Health Promotion at Local Level in Norway: The Use of Public Health Coordinators and Health Overviews to Promote Fair Distribution Among Social Groups".

Health promotion is a complex activity that requires analytic methods that recognize the contested nature of it definition, the barriers and supports for such activities, and its embeddedness within the politics of distribution. In this commentary I critique a recent study of municipalities' implementation of the Norwegian Public Health Act that employed analysis of "yes" or "no" responses from a large survey. I suggest the complexity of health promotion activities can be best captured through qualitative methods employing open-ended questions and thematic analysis of responses.

Governmental Illegitimacy and Incompetency in Canada and Other Liberal Nations: Implications for Health.

The welfare state literature on developing nations is concerned with how governmental illegitimacy and incompetency are the sources of inequality, exploitation, exclusion, and domination of significant proportions of their citizenry. These dimensions clearly contribute to the problematic health outcomes in these nations. In contrast, developed nations are assumed to grapple with less contentious issues of stratification, decommodification, and the relative role of the state, market, and family in providing economic and social security, also important pathways to health.

Narrative review of affinities and differences between the social determinants of oral and general health in Canada: establishing a common agenda.

Background: This article overviews Canadian work on the social determinants of oral and general health noting their affinities and differences.

Methods: A literature search identified Canadian journal articles addressing the social determinants of oral health and/or oral health inequalities. Analysis identified affinities and differences with six themes in the general social determinants of health literature.

Canada considers a basic income guarantee: can it achieve health for all?

There is little doubt that the implementation of a Basic Income Guarantee (BIG) in Canada and other liberal welfare states would alleviate some of the most egregious examples of absolute poverty that contribute to poor health such as lack of adequate food and shelter and inability to meet basic household and personal needs. BIG would likely improve the health of the most disadvantaged by moving them closer to the relative poverty line. Yet, advocacy for and implementation of BIG carries potential dangers.

Assuming policy responsibility for health equity: local public health action in Ontario, Canada.

In Canada's liberal welfare state the public is given little exposure by governmental authorities to the importance of promoting health equity through public policy action on the social determinants of health (SDoH). Not surprisingly, Canada lags in implementing health equity-enhancing public policy. In Ontario, Canada's most populous province, a local public health unit (PHU) took on the task of promoting health equity by developing the video animation Let's Start a Conversation about Health and Not Talk about Health Care at All.

Labonté Identifies Key Issues for Health Promoters in the New World Order Comment on "Health Promotion in an Age of Normative Equity and Rampant Inequality".

For over 35 years Ronald Labonté has been critically analyzing the state of health promotion in Canada and the world. In 1981, he identified the shortcomings of the groundbreaking Lalonde Report by warning of the seductive appeal of so-called lifestyle approaches to health. Since then, he has left a trail of critical work identifying the barriers to - and opportunities for -health promotion work.

New hypotheses regarding the Danish health puzzle.

Aims: Nordic welfare states have achieved admirable population health profiles as a result of public policies that provide economic and social security across the life course. Denmark has been an exception to this rule, as its life expectancies and infant mortality rates since the mid-1970s have lagged behind the other Nordic nations and, in the case of life expectancy, behind most Organisation for Economic Co-operation and Development nations.

Methods: In this review paper, we identify a number of new hypotheses for why this may be the case.

Understanding action on the social determinants of health: a critical realist analysis of in-depth interviews with staff of nine Ontario public health units.

Background: Addressing the social determinants of health (SDH) is identified as a role for local public health units (PHUs) in the province of Ontario. Despite this authorization to do so there is wide variation in PHU practice. In this article we consider the factors that shape local PHU action on the SDH through a critical realist analysis.

Beyond policy analysis: the raw politics behind opposition to healthy public policy.

Despite evidence that public policy that equitably distributes the prerequisites/social determinants of health (PrH/SDH) is a worthy goal, progress in achieving such healthy public policy (HPP) has been uneven. This has especially been the case in nations where the business sector dominates the making of public policy. In response, various models of the policy process have been developed to create what Kickbusch calls a health political science to correct this situation.

Ideological and organizational components of differing public health strategies for addressing the social determinants of health.

Despite a history of conceptual contributions to reducing health inequalities by addressing the social determinants of health (SDH), Canadian governmental authorities have struggled to put these concepts into action. Ontario's-Canada's most populous province-public health scene shows a similar pattern. In statements and reports, governmental ministries, professional associations and local public health units (PHUs) recognize the importance of these issues, yet there has been varying implementation of these concepts into public health activity.

Challenges to promoting health in the modern welfare state: the case of the Nordic nations.

Aims: Finland, Norway, and Sweden are leaders in promoting health through public policy action. Much of this has to do with the close correspondence between key health promotion concepts and elements of the Nordic welfare state that promote equity through universalist strategies and programs that provide citizens with economic and social security. The purpose of this article is to identify the threats to the Nordic welfare states related to immigration, economic globalization, and welfare state fatigue.

Latest OECD figures confirm Canada as a public health laggard.

Despite the Canadian public health community's commitments to promoting public policy that supports health, evidence indicates that Canada's public health picture continues to decline. This may be due in part to the failure of public health agencies and local public health units to engage in public policy advocacy and public education about the social determinants of health. Examples of such activities by local public health units are now available and provide a model for such activity.

Adolescence as a gateway to adult health outcomes.

Adolescence has long been regarded as a transition from childhood to adulthood. More recently it is become a concern of those wishing to avoid adverse health outcomes during middle and late adulthood. Most of this effort has been focused on behavioural risk factors such as tobacco and excessive alcohol use, physical exercise habits, dietary habits, as well as sexual and injury-related behaviours.

Educating the Canadian public about the social determinants of health: the time for local public health action is now!

Despite Canada's history of developing health promotion and population health concepts, Canada falls behind other wealthy nations in having these ideas implemented in the form of public policy that strengthens the social determinants of health (SDH). Much of this has to do with the lack of awareness by Canadians about the SDH that stems from the lack of media reporting on the determinants of health and the unwillingness of most local public health units across Canada to raise these issues in a consistent manner. Canada is not unique in this situation.

The dynamics of the relationship between diabetes incidence and low income: longitudinal results from Canada's National Population Health Survey.

Unlabelled: This paper sheds light on the dynamic relationship between people's experiences of low income and the development of type 2 diabetes (T2DM) by moving beyond the static perspective provided by cross-sectional studies to a long-term approach informed by longitudinal analyses.

Methods: We analyzed data from the Canadian National Population Health Survey (NPHS) conducted by Statistics Canada from 1994 to 2007. The longitudinal sample is composed of 17,276 respondents (8046 males, 9230 females) 12 years of age or older.