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Planning for Action: What Determines Health?

Saskatchewan Health and the Prairie Region Health Promotion Research Centre at the University of Saskatchewan (1997).

Annotation By: Lorraine Telford, Health Communication Unit

Video One: "What Determines Health? Presentation by David Butler-Jones (80 Minutes)

This video includes a formal presentation as a satellite conference to a broad group of listeners across the prairies by the CMOH of Saskatchewan Health, followed by phone and faxed questions regarding

the determinants of health and their role in the health care system.

The first 45 minutes includes a presentation by David Butler-Jones starting with a view of the state of the current health care system vis a vis health. The presentation of traditional epidemiological analyses leads to accessing the principles and causes of all issues in communities, the determinants of health and well being. Nutrition, housing, smaller families, sanitation and clean water, pasteurisation, and immunisation are identified. Further health reports, especially those from England, are reported to identify the factors that have the greatest impact on IMR, and other measures of health: income equity and social status, education, social support networks, employment and working conditions. A case is made to demonstrate that more health care workers do not equal better health.

The questions from the listeners range from "How can we get decision-makers to realise the importance of the determinants and act?" to questions regarding regionalization of health services and its effectiveness.

Video Two: Lifetime of Benefits - Presentation by Robert A. Faulkner (Ph.D.) (65 Minutes)

Bob Faulkner is Dean of the College of Physical Education at U of S. He takes a strong position regarding the importance of physical activity in wellbeing and health problem prevention. He covers the

health benefits of physical activity, costs/benefits, public health messages, individual concerns about being active, and the importance of activity before and during adolescence. Factors, which have lowered the amount of physical activity for children, are described (TV, etc).

The session is followed by questions from the broad satellite audience. For example, some questions stimulated discussion regarding school policy and QDPE, municipal programming priorities, benefits of physical activity for lower SES, and workplace programs. The importance of the social element of many physical activities was identified.

Video Three: Taking Action and Three Saskatchewan Strategies

Georgina Bell Woodward, Saskatoon District Health (100 Minutes)

Georgina asks the question "What can I do tomorrow?" and uses real and practical examples to describe the Ottawa Charter's five action strategies (create supportive environments, strengthen personal skills, strengthen community action, reorient health services, and build healthy public policy.

(Antecedents for the latter are - belief in change, access to power, and tenacity/stamina). She acknowledges that others have been involved in addressing the determinants, sometimes long before health, so we in health can acknowledge this and build on what they have done. The Ottawa Charter is touted as the first official document referring to the determinants of health: peace, shelter, education, food, stable ecosystems, sustainable resources, and equity. These determinants are more value laden than the current usage of the term "determinants of health." Food security is analysed as an example. Personal, professional and institutional change must all occur to create the conditions necessary for health, and Georgina discusses these.

Members of three exemplar projects describe their activities in more detail:

1. AWARE Project: Teachers who are parents and members of the agricultural community developed a project to help children (4-12) access information for better decision making for their health and safety. A locally produced video describes the process of needs assessment and the main educational content of the project (air, water, plants, animals, soil and lifestyles).**

2. Poverty, Health and the Minimum Wage: The chair of one health district board describes their leadership in making a provincial submission to increase the minimum wage. This occured within two

months of the new district being formed by the provincial government - before exploring mission, definition of health, etc. Community groups, some decades old, were involved in sponsoring the lobby. Several community events were organized including four all-candiates forums in one year! Access was an important sub-theme, and several citizens volunteered to provide transportation and child care for others to get to the events. The business community responded negatively and quickly. The board had to be informed and articulate on the relationship between health and wealth. The lobby was successful.****

3. Bicycle Helmet Legislation (Community Mobilization) An initiative to prevent injury of cyclists is described. The slides and the speech provide a detailed review of the planning to date of the initiative.*

Submitted by:

Lorraine A. Telford, The Health Communication Unit

at the Centre for Health Promotion,

Rm 213, 100 College Street, The Banting Institute,

University of Toronto, Ontario, Canada M5G 1L5

Ph : (416) 978-1188 Fax: (416) 971-2443


An extensive listing of videos that the Prairie Region HP Research Centre has collected on health promotion, determinants of health, community development and much more is accessible on the Internet at or by contacting:

Bonnie Sproat, Research Assistant

Prairie Region Health Promotion Research Centre

University of Saskatchewan

Health Sciences Building

107 Wiggins Road


Phone: (306) 966-7939 Fax: (306) 966-7920