A discourse analysis of the social determinants of health

The social determinants of health (SDH) concept is common to Canadian policy documents and reports. Yet, little effort is undertaken to strengthen their quality and promote their more equitable distribution through public policy action. Much of this has to do with the SDH concept conflicting with current governmental approaches of welfare state retrenchment and deference to the dominant societal institution in Canada, the marketplace. In addition, many SDH researchers and implementers of SDH-related concepts are reluctant to identify the public policy implications of the SDH concept. The result is a variety of SDH discourses that differ greatly in their explication of the SDH concept and their implications for action. This article identifies these various SDH discourses with the goal of noting their contributions and limitations in the service of advancing the SDH agenda in Canada and elsewhere.