Social Determinants of Health: The Canadian Facts (2nd edition, 2020)
Dennis Raphael, Toba Bryant, Juha Mikkonen and Alexander Raphael.

Foreword for the 2nd edition by Claire Betker
RN, PhD, CCHN(C) Scientific Director
National Collaborating Centre for Determinants of Health, St. Francis Xavier University.

Foreword for the 1st edition by Hon. Monique Bégin
Former Minister of National Health & Welfare of Canada and
Member of WHO Commission on Social Determinants of Health.

Published in August 2020. 93 pages. Oshawa: Ontario Tech University Faculty of Health Sciences and Toronto: York University School of Health Policy and Management. Funding for the 2nd edition was provided by Ontario Tech University Faculty of Health Sciences. 

Download "Social Determinants of Health: The Canadian Facts", 2nd edition.

Order a printed copy: (Canada) - (US and other countries)


The primary factors that shape the health of Canadians are not medical treatments or lifestyle choices but rather the living conditions they experience. These conditions have come to be known as the social determinants of health. This information – based on decades of research and hundreds of studies in Canada and elsewhere – is unfamiliar to most Canadians.

Canadians are largely unaware that our health is shaped by how income and wealth is distributed, whether or not we are employed and if so, the working conditions we experience. Our health is also determined by the health and social services we receive, and our ability to obtain quality education, food and housing, among other factors. And contrary to the assumption that Canadians have personal control over these factors, in most cases these living conditions are – for better or worse – imposed upon us by the quality of the communities, housing situations, work settings, health and social service agencies, and educational institutions with which we interact.

Improving the health of Canadians requires we think about health and its determinants in a more sophisticated manner than has been the case to date. Social Determinants of Health: The Canadian Facts considers 17 social determinants of health:

1. Income and Income Distribution
2. Education
3. Unemployment and Job Security
4. Employment and Working Conditions
5. Early Child Development
6. Food Insecurity
7. Housing
8. Social Exclusion
9. Social Safety Net
10. Health Services
11. Geography
12. Disability
13. Indigenous Ancestry
14. Gender
15. Immigration
16. Race
17. Globalization

The publication outlines why they are important; how Canada is doing in addressing them; and what can be done to improve their quality. The purpose of the document is to provide promote greater awareness of the social determinants of health and the development and implementation of public policies that improve their quality.

2010 edition

Download the 1st edition in English (2010):

"Social Determinants of Health: The Canadian Facts" PDF, 4Mb]

Download the 1st edition in French (2011):

"Déterminants sociaux de la santé : les réalités canadienne" PDF, 4 Mb]]