Local Actions for Reducing Health Inequalities

By Jalil Safaei 

13275The Social Determinants of Health (SDOH) discourse is getting more practical for improving the health of populations and reducing health inequalities. Following the WHO Commission on SDOH Report in 2008 (Closing the Gap in a Generation), which emphasized acting on SDOH, a recent significant report published by the British Academy for Humanities and Social Sciences titled – “If You Could Do One Thing …” Nine local actions to reduce health inequalities – identifies nine local actions that could be implemented at the local level to improve the community health and reduce health inequalities in the community.

The report consists of nine chapters, each devoted to a specific local action for reducing health inequality. The actions correspond to and address various social determinants of health and health inequality. They include:

  1. Implementing a living wage
  2. Increasing early childhood education
  3. Implementing 20 mph speed limits for cars in residential areas, by shops and   schools
  4. Tackling health-related ‘worklessness’: a ‘health first’ approach
  5. Building ‘age-friendly’ communities and cities
  6. Using participatory budgeting to improve mental capital
  7. Improving the employment conditions of public sector workers
  8. Increasing the scope of adult and further education
  9. Evaluating policies for evidence of cost effectiveness

Written by prominent scholars from various social sciences, the report is a welcome and timely interdisciplinary document for guiding local actions to reduce health inequalities in the communities where people are born, live, work and age. The report provides evidential support to some of the initiatives suggested by our local public health advocates in British Columbia.


Jalil Safaei is a PHABC Board member and Associate Professor at the University of Northern British Columbia.

Need We Say More

By Ted Bruce

Need we say more? Apparently yes. The evidence on the impact of low income on health such as that described by Dr. Patricia O’Campo just keeps piling up.

When many people working full time cannot get out of poverty. When many people working full time cannot get out of poverty. And when we ignore studies showing that acting on critical social determinants of health such as quality child care makes economic sense for our society, it is clear there is something very wrong. The need to invest in poverty reduction is an elephant on top of the table not under it. Fortunately, we know from other public health efforts that the evidence eventually does lead to action. Just consider the 12 great achievements in public health as recently documented by the Canadian Public Health ssociation: http://www.cpha.ca/en/programs/history/achievements.aspx.

It can be frustrating to see a lack of action, but that is all the more reason for public health practitioners to speak out about the evidence. Thank you Dr. O’Campo.

Ted Bruce is the Past President of the PHABC

Further reading:

Social policy is health policy. Vancouver Sun Opinion: Poverty linked to multiple health problems in new mothers, study finds | Patricia O’Campo |  August 28 2013

BC’s welfare recipients need immediate relief | Seth Klein, Lorraine Copas, Adrienne Montani | April 24 2012

2012 Child Poverty Report Card | First Call: BC Child and Youth Advocacy Coalition | November 2012

15 by 15: A Comprehensive Policy Framework for Early Human Capital Investment in BC | Human Early Learning Partnership | August 2009