Most Canadians believe that their experiences of health and illness are shaped by genetics, medical care and lifestyle choices. Governments, the media and disease associations reinforce this perception by pointing to medical research and a healthy lifestyle as the keys to health. About Canada: Health and Illness tells a different story. In this new, updated edition, Dennis Raphael shows that living and working conditions, income, employment and quality of education, as well as access to food, housing and social services — the social determinants of health — are what dictate the health of Canadians. And these social determinants are shaped by the public-policy decisions of Canadian governments. Whether you stay healthy or become ill has more to do with policies, laws and regulations than genetics or lifestyle. Over the past thirty years, policymakers — operating under the influence of neoliberalism — have threatened health by allowing the growth of corporate power, which has led to growing inequality in these social determinants of health. This book is a wake-up call to Canadians. Public pressure needs to be put on elected representatives to create policies that are in the interest of the majority of Canadians, not just the wealthy.
Living a long, healthy life is one obvious goal of pretty much all of us. We are told, over and over, to change our “lifestyles” and accept that if we become ill, we have likely brought it on ourselves. Yet, hundreds of studies, over the past four decades, tell the real story: the living and working conditions we experience every day play a determining role in our health. How income and wealth, housing, education and adequate food are distributed, whether or not we are employed, and the working conditions we experience — not medical treatments nor so-called wellness lifestyles — determine whether we stay healthy or become ill. These living and working conditions reflect the social inequalities that are associated with social class, gender, race and other social locations in Canadian society. The third edition of Health and Illness shows how inequitable distribution of the social determinants of health are determined by public policy decisions. Dennis Raphael updates information that connects health and illness to the worsening levels of inequality in Canada – the rich are getting richer and the rest of us are getting sick! This edition also includes a chapter on the social determinants of who got sick and died from COVID-19. The experiences during the COVID-19 pandemic make the clear case that we need to restructure work and living conditions through public policy that more equitably distributes economic resources. It is only through such actions that we will be able to promote the health of Canadians and prevent illness in an effective manner.
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