Social Determinants of Health: Indicators

Social Determinants of HealthWe’re working on our Common Agenda, including fine-tuning long-term outcomes, setting targets & selecting indicators for our Collective Impact Initiative.

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.”


A Theory of Everything (for children & youth)

A small working group as been exploring Executive Function & Toxic Stress as a possible theoretical framework for our Collective Impact initiative.

We’re audacious enough to be seeking a ‘Theory of Everything’.

A Theory of Everything

Hmmm, a Theory of Everything from a Child, Youth & Family point of view...
Hmmm, a Theory of Everything from a Child, Youth & Family point of view…

Physicists have been pursuing an ultimate theory ~a theory of everything~ for centuries. A Theory of Everything (from a Physicist’s point of view) would be an unbreakable theoretical framework that would explain all the physical aspects of the universe.

We are seeking a Theory of Everything from a Child, Youth & Family point of view.

Or, as close as we can get.

How will we know when we find it?

First we need criteria by which to assess such a theory.

Here’s a start:

Criteria for an Overarching Theoretical Framework

Does this theory enable us to:

  • Identify assets (what is currently working) in the region?
  • Improve (& resource) what is already working?
  • Identify gaps & fill them?
  • Work cross-culturally?
  • Take a strengths-based approach?
  • Engage the whole community (multi-sectorially) to collectively improve population-level outcomes for children, youth & families?
  • Change policies at the regional & provincial level?
  • Share/scale innovations?
  • Meet the needs of young people from the prenatal period through to the transition to adulthood?
  • Get stuff done (not just talk about it!)

What do you think about these criteria?

What other criteria should we include?

A Common Agenda

the Veronica mafiaA Common Agenda is one of the 5 conditions of Collective Impact.

The Common Agenda includes a collective goal. This month we’ve been crafting a goal statement. Here are four variations, for rework:

  1. Children and youth in the Capital Region are healthy and happy from prenatal through to post-secondary; thriving and reaching their full potential.
  2. Happy, healthy children and youth today; caring, creative, responsible adults tomorrow. (Child & Youth Network statement)
  3. Together, improving the health and well-being of all children, youth and families in the Capital Region.
  4. Children, youth and families in the capital region: strong, capable and resilient; rich with wonder and knowledge. (adapted from Reggio Emilia)

Please send suggestions & refinements to or make your comments below.

What Makes a Good Childhood?

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What Makes a Good Childhood?

Prenatal to Post secondary Partners have been asking the question: What Makes a Good Childhood?

We’ve collectively identified a working list of features of a good childhood, organized into the following seven themes:

Basic Needs

Housing, food & income

Play & Nature

Opportunities for creative, non-structured play, including freedom to run, play & explore.


Safe homes, safe schools & safe communities

Learning & Community Contribution

Access to a continuum of learning experiences & opportunities to contribute.


A sense of belonging & feeling wanted. Continued acceptance & unconditional regard even when young people become hard to appreciate or youth become intimidating.

Healthy Relationships (Informal Networks)

Love, enduring primary attachment, family, community, friendships & role models.

Community & Health Services (Formal Networks)

Including: Universal services such as recreation resources, neighborhood houses, and health care professionals. Preventative or safety-net supports such as mental health services and crisis response.

What do you think?

Tell us! What have we missed?

Collective Impact

The Child & Youth Health Network is using a Collective Impact as an approach to improve outcomes for young people throughout Southern Vancouver Island.

Collective Impact is a complexity-theory based approach that engages cross-sectorial partners for system change. Collective Impact enables stakeholders to use existing resources to improve the health and sustainability of their communities by: 1) convening around a common agenda that is supported by locally-generated data; and 2) redesigning initiatives to ensure mutually reinforcing activities. Due to its effectiveness, Collective Impact is being taken up by communities across North America and around the globe, as a way for diverse stakeholders to address some of our most complex 21st-century challenges.

The following are resources on the Collective Impact model.

Collective Impact in Action


  • The original Collective Impact paper, with links to other papers published by the Stanford Social Innovation review.
  • A recent, comprehensive text resource is ‘Collective Insights on Collective Impact’ from the Stanford Social Innovation Review is comprised of 9 short articles and includes some of the most recent thinking about Collective Impact.




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For more information contact Petra Chambers-Sinclair, Coordinator, Child & Youth Health Network Collective Impact initiative: