To engage in shared measurement, we need to adopt shared indicators that can be measured by each service-delivery partner in the initiative, so we can track our collective progress toward our goals.
We know much of this work has already been done, and can be adapted to our purposes.
For example, here’s a list of indicators for monitoring the social determinants of health (SDH) found on the Action:SDH website (find the full list here). The following relate directly to young people in a Canadian context:
- Proportion of young people not in school or employment, by age and sex;
- Literacy rate;
- Completion of primary/secondary education by ethnic/ “race” group in a country;
- Newborns with low birth weight (% by mother’s education);
- Children aged <5 years with moderately or extremely low values for weight and height;
- Prevalence of obesity (by wealth quintiles).
Applying the Social Determinants of Health
Sam Bradd graphically documented strategic-level dialogue around the Social Determinants of Health by the the First Nations Health Authority, First Nations Health Directors Association, and First Nations Health Council in BC in October 2013. Find the graphics he created based on that dialogue here.
Upstream is a Saskatchewan-based organization devoted to using the Social Determinants of Health to leverage social change. According to Upstream: “Upstream interventions start at home. When everyone has access to adequate housing, nutritious food, and support for early childhood development, we are thinking and acting upstream.”
Measuring the Social Determinants of Health
As for using the Social Determinants of Health for measurement, the Action: SDH site notes that “Effective action on social determinants requires monitoring and measurement to inform policy-making, evaluate implementation, and build accountability. Inequities in health outcomes, social determinants, and the impact of policies must be monitored. Key requirements are collecting and monitoring indicators of social determinants from different sectors, linking with health outcomes, and monitoring inequities; establishing whole-of-society targets towards the reduction of health inequities; and disaggregating data to better understand baseline levels and potential impacts of policies.
Indicators selected for monitoring policies aimed at reducing health inequities need to be clearly understood by policy-makers across the different sectors that influence the social determinants as well as by communities. Thus simpler measures may be more transparent and easier to interpret than complex summary measures.”