In September, Health Promotion Ontario hosted its 26th conference. As with last year’s conference the theme was the social determinants of health. It was encouraging to see a strong emphasis on moving public health upstream (focusing on systemic and structural changes which affect daily living conditions and affect the distribution of power and resources).

Fitting with this theme, Dr. Ryan Meili, the keynote speaker, launched Upstream, “ a movement to create a healthy society through evidence-based, people-centred ideas.” Dr. Meili argued that the social determinants of health are generally understood and he provided an opening for action as well as a way to measure progress. His ideas are documented in a recently published book  and at TEDX Regina.

Dr. Charles Pascal, professor at OISE, University of Toronto and former Deputy Minister of the Ministry of Community and Social Services reflected that intersectoral action is largely absent from the real function of most government departments. He noted that we need to stop doing the wrong things (system fragmentation, hardening of the categories and too much downstream spending) and move upstream towards better integration and accountable leadership. One simple accountability tool would be the application of a health equity and social determinants of health lens to all decisions and policies that go to cabinet.

It was refreshing to hear Steve Buist (investigative reporter) and Paul Berton (editor-in-chief) speak about Code Red, an investigative project of the Hamilton Spectator that examined the connections between health and poverty by mapping the neighbourhood health of Hamiltonians. This is an excellent example of a newspaper partnering with academia to produce data and to make it available to the public. Hamilton Sector has continued this sustained focus on the impact of income and poverty on health with projects like BORN, which demonstrated that neighbourhoods with low income and poor education have a higher proportion of teen mothers and low birth-weight babies and less access to early prenatal care. An interesting question emerged from the audience – If a newspaper is doing this work and getting rewarded for it why aren’t more papers following suit?

I left the conference with the reminder that while more public health organizations are having conversations about their roles in improving the social determinants of health and health equity there is still lots to be done.

It's no surprise that Dr. Pascal’s reminder rings true – sometimes success can be a real barrier if we don’t keep pushing ourselves to do more and to do better.