Second Opinion Chapter 8Environment & Health

What are some negative effects of industrial production on our food supply? How does our social location affect our access to good food?
Industrial production of food causes major damage to the environment. It also causes health related threats to humans, damages rural communities, causes harm to workers and also creates negative effects on animal welfare.

p.

147. There are more reported cases of prostate cancers, melanoma, and multiple myeloma among farmers due to pesticide use. Also Persistent organic compounds may accumulate in the
animals tissues exposing the consumers to drug residues.(p.145) Animals are raised in very unbearable conditions in feedlots. These animals are given hormones, antibiotics and growth enhancing drugs to speed their growth and reach the required weight while minimizing operational costs. (Abramson, Zelda, 2012, p. 145)

p. 195) Food insecurity can be linked to low income. As mentioned in chapter 13 strategies focus on food as the problem, rather than
(McIntyre, Lynn & Krista Rondeau 2009,

p. 201 To eradicate food insecurity in Canada the focus should be more on income as the proplem and not food as well, income as a main factor in contributing to food insecurity should be addressed by making housing, food daycares more affordable.
(McIntyre, Lynn & Krista Rondeau, 2009) Environmental racism is a key factor in examining how
environmental inequalities relates to food security. p.

205 For example the Aboriginal people in the territories and reserves such as Yukon, NWT, and Nunavut experience the most structural food insecurity in Canada. p. 208 6. How does inadequate housing negatively impact our health? What other aspects of our surrounding should we consider? Healthy homes contribute to a healthy population by meeting basic physical needs such as water, food, and shelter as well as meeting psychological and social needs. Poor housing exposes people to environmental hazards causing infectious and chronic diseases, and mental and emotional health problems as well as injuries.. Second Opinion Chapter 8Environment & Health

p. 158 Environmental racism refers to disproportionate environmental risks that Aboriginal and racialized communities are exposed to through deliberate policy and planning practices. p. 160 A physician who is untrained in environmental health may not think about asking about exposure to environmental contaminants *although local physicians often do make these connections+.

p. 161 The role of government policy-makers, then, is to decide whether one in a million deaths is an acceptable level or to increase or decrease the risk to what is deemed acceptable. Acceptable levels of drug residue, bacteria, pollutants, emissions, and radiation level are decided through political processes that are heavily influenced by industrial interests, and that are not accessible to the public.

Second Opinion Chapter 8Environment & Health p. 144 there are four known health effect from smog: respiratory disease cardiovascular disease; allergies; and neurological effects p. 93 Ozone depletion causes skin cancer, cataracts, and immunosupressive diseases. p. 145 Persistent organic compounds (POPs) accumulate in fatty tissues and up the food chain. p. 146 The arctic has been a cold trap for industrial pollutants, exposing Inuit people to one of the most contaminated environments on earth.

p. 147 Due to pesticide use, farmers experience such cancers as prostate, melanoma, and multiple myeloma at much higher rates than the rest of the population. p. 150 USAID invested approximately $80,000,000 to technify the coffee industry in the Caribbean and Latin America Coffee is the third most heavily sprayed crop after cotton and tobacco. p. 151 The Walkerton water contamination case in 2000 was an early example of the violence of neoliberal deregulation. 2300 out of 5000 became ill and seven people died. Farming practices and ministry cutbacks caused the crisis.

p. 157 Aside from their own inherent epic health risks (see the 2011 crisis at Fukishima), nuclear reactors are based on extensive uranium mining, which has had devastating health impacts on Aboriginal communities. p. 158 Environmental racism refers to disproportionate environmental risks that Aboriginal and racialized communities are exposed to through deliberate policy and planning practices. p. 160 A physician who is untrained in environmental health may not think about asking about exposure to environmental contaminants *although local physicians often do make these connections+.

Health Inequities Chapter 12Healthy Space p. 239 Focus on womens everyday home-based labour and the production of healthy space. Chapter also draws attention to the differential supports available to women arriving in Canada through family reunification and refugee categories. Note: several aspects of

Canadian immigration policies download health care to individual women, for example, when women arrive as family class, as domestic workers through the LCP, or on a supervisa

p. 240 Tension between political economy approach and a focus on everyday agency p. 240 The creation of healthy space must be understood in transnational contexts, which are different for Punjabi Sikh and Afghan women p. 241 Macro structures affect the micro processes of daily health practices. Intersectionality is better understood from the bottom up Note: I think of this as connecting the specific to the universal p. 243 Semi-structured interviews in which ten Punjabi and ten Afghan women talked about mother work, paid work, and health practices; follow-up groups

p. 245 state migration policy re-inscribed their primary responsibility for health and care work p. 245 Women arriving through family reunification had dense social networks, while women arriving as refugees experienced severing of ties and loss p. 247 Punjabi women in the Vancouver area could find all the necessary ingredients for food preparation, while this was more time consuming and travel intensive for Afghan women p. 248 The home was a safe site for the production of healthy food, admitting Canadian tastes as well as adhering to valued cultural food practices.

p. 249 Punjabi women could connect to knowledge of, and ingredients for, home remedies p. 250 For Afghan women, Instead of herbs, the country is filled with landmines. p. 251 Afghan women had to seek care primarily through the Canadian health system embedded in unequal relations of race, gender, class, and space. p. 253 Womens work of food preparation, health care, and prayer build the home and neighbourhood as healthy spacein material, social, and symbolic dimensions.

Social Determinants Chapter 15Housing p. 221 *M+ore than one in five Canadian households are unable to find affordable and healthy homes, and more than 3000,000 people will experience homelessness every year. *1% of the population+ p. 221 By the late 1990s, Canada became one of the few countries in the world without a national housing strategy. p. 222 Housing was entirely divested to the private sectorthere is no profit in low to middle income housing; there is profit in large scale rental.

p. 222 Miloon Kothari, the 2007 UN special rapporteur on housing, found that hundreds of people have died, as a direct result of Canadas nation-wide housing crisis. p. 223 Also in 2007, Canada Housing and Mortgage Corp. found that rents are increasing much faster than income, existing housing is aging, there is no unified access point for accessible housing, and household crowding has increased the hidden homeless. p. 224 The tax-based programs to help homeowners are many times more costly than the affordable housing programs for lower-income Canadians.

p. 224 In 2003, TD Bank argued that affordable housing is smart economic policy. p. 226 Studies have found homelessness all over the countryin small towns and large cities. p. 226 Dimensions of homelessness include people staying with friends and family, and people leaving violent households. p. 227 Some First Nations people leave the appalling conditions on reserves for urban areas, only to have a large number of them join the ranks of homeless people. Note: If our first defense against homelessness is family and friends, what happens when we are isolated and our networks are stressed?

p. 228 Post-WWII policy delivered 600,000 units of low- income housing. Note: How does this history link to current patterns of ownership and privilege? p. 229 Low-cost units cannot provide adequate returns to investors in the property market. Note: This sounds similar to the argument for public health care. Perhaps affordable and life-saving housing may only be possible through social policy. p. 230 Tenant households across the country face a patchwork of laws offering diminishing amounts of legal protection. p. 231 A 2001 study showed 2/3 of renters could not afford average rents.

Social Determinants Chapter 16Housing & Health p. 235 This chapter considers the health effects of homelessness; of poor housing conditions; and of excessive housing costs on the other SDH. p. 236 It is important to consider the interconnections between housing programs, subsidy eligibility and allocation, income security, access to credit, security of tenure, transportation, and service needs. p. 236 Women are at increased risk of eviction when dealing with loss of job, pregnancy, or disability.

p. 237 Housing core need can be analyzed in terms of: affordability (paying more than 30% of income on housing); suitability (overcrowding); and adequacy (state of repair, bathroom access) p. 238 A 1944 UK report: The evidence is overwhelming, and it comes from all over the world the worse people are housed, the higher will be the death rate. p. 239 A 2004 Toronto study found that one out of 200 homeless women died during the one-year study. p. 240 Health is affected by lead, asbestos, poor heating, lack of smoke detectors, radon, dust mites, smoke, dampness, mould & overcrowding.

p. 240 Living in poor housing conditions in the past and in the present make independent contributions to the likelihood of poor health. p. 243 Impossibility of experiments and controlled trials on housing effects, and failure to accept/pursue ethnographic research. p. 243 Long term crisis-response leads to depression, vulnerability to infection, diabetes, high blood pressure, and the related risk of heart attack and stroke. Note: Consider diabetes epidemics in relation to exposure to violence and precarious working and living conditions.

p. 244 Ethnographic studies of peoples housing experiences could document the meaning that housing provides to people and how these affect health. p. 245 The author outlines a policy change model where professional policy analysts share their instrumental knowledge with citizen activists interactive and critical knowledge. p. 247 Educational and community mobilization strategies are needed to draw attention to the relationship between housing and health. p. 248 Neoliberal policies have reduced investments in cities and have contributed to the housing crisis.

7. How does the organization of work affect our health? What changes might we make to the way our work is organized to make it safer and healthier?

Social Determinants Chapter 6Worker Insecurity p. 88 *L+ayoffs are no longer used solely in response to a downturn in the economy; they are also used to rationalize operations in thriving markets. p.89 Firms have adopted task flexibility and numerical flexibilitythe former refers to redesigned practices, self-directed work teams, and just-in-time production; the latter refers to layoffs, contracting, part-time work, and overtime. p. 91 Intensification refers to working at high speed, with high effort and tight deadlines.

p. 91 A 2001 study showed that one in three Canadian workers experiences a conflict between work and family. p. 92 Canada has the highest work-related mortality rate of OECD countries. There were 1,097 workplace fatalities in 2005. p. 92 Intensification of work and increasing workplace insecurity may affect health in the following ways: stress induced physiological changes; increased risky health behaviour; loss of social support; and inadequacy of income.

p. 93 *I+ndividuals working continuously at high speeds report roughly twice the rates of stress, injuries, and back, neck, and shoulder pain as individuals who never work at high speeds. p. 93 Disturbed relaxation ability, correlated with elevated blood pressure and coronary heart disease, is related to working more than 50 hours per week. p. 93 Downsizing has been linked to increased workplace fatalities, workplace accidents, musculoskeletal injuries, and psychiatric disorders. p. 93 *E+mployees who became disabled after experiencing downsizing took substantially longer to recover.

p. 94 *S+tress and strain in todays flexible economy is related not just to the workers job, but to the workers broader experience of the organization and arrangements of employment p. 94 Developing *a+ shared vision of good or decent work is the first step toward *preventing+ unhealthy workplace practices. p. 95 One possibility *for change+ is through international trade agreements that incorporate minimum labour standards. p. 96 There could be a requirement for pro-rating benefits for temporary and parttime workers.

Social Determinants Chapter 7Unhealthy Workplace p. 99 Given the simple fact that the experience of work dominates the lives of most working age people, it seems plausible that the close link between socio-economic status and health runs, in significant part, through different work experiences. p. 99 Poor employment conditions include: risk of injuries and occupational disease; rapid pace, high demands, and repetitive labour process; arbitrary power-wielding; and the failure to meet human developmental needs.

p. 99 High job strain is defined as high psychological demands with a low degree of control over the workplace. p. 100 Psychosocial stress includes feeling depressed, bitter, cheated, vulnerable, frightened about debts or job or housing insecurity; *feeling+ devalued, useless, helpless, uncared for, hopeless, isolated, anxious. p. 100 *A+n increasingly well-educated and skilled workforce is associated with rising levels of stress. p. 100 *E+ven large pay differences are an imperfect proxy for large class differences in the quality of employment.

p. 100 Work is better seen as a potential sphere for the development of individual human capacities and potentials. p. 101 The shift in the 1980s and 1990s from stable employment to long-term unemployment has been relatively well studied. Today it is more common to see alternation between short-term unemployment and precarious employment. We dont yet know the long term impacts of this situation. p. Our job market is characterized by frequent transitions between low-paying jobs.

p. 102 The EU has (or had!) greater pay equality due to regulations that limit employers power to lay off long-tenure workers limits on renewals of temporary contracts and widespread collective bargaining. p. 102 In Canada, the dominant ethos is that heavy sticks are needed to drive the unemployed into available low-wage jobs. Our minimal and deeply punitive social welfare system is designed to make even poverty-line wages look attractive. p. 102 Healthy jobs have better health-related benefits, while unhealthy jobs have limited or no benefits.

p. 104 To get around compensation board rating systems, employers contract out the most dangerous jobs, and persuade their own workers not to report injuries. p. 104 Contract employees may not know that they are protected by legislation and workers compensation programs. p. 104 The nature of workplace injuries and conditions is also changing. There has been a disturbing upward trend in repetitive strain and other softtissue injuries associated with highly repetitive machine and keyboard work.

p. 104 Injury rates are high in manufacturing and construction (40% of reported injuries with 20% of workforce), yet injury rates are also high in retail and health and social services industries. p. 105 Musculoskeletal pain and chronic back pain are on the increase, especially with an aging workforce in physically demanding jobs p. 105 There is rapidly-rising rate of chronic stress- related disability, which often has workplace roots, but cannot be identified as solely work-related or solely attributable to a specific job and employer. p. 105 The workers compensation system demands proof of cause and effect.

p. 106 By industry, the incidence of stress by too many demands on hours is highest in education, health, and social services at over 40 percent. p. 108 *W+ork is increasingly taken home, especially with the rise of laptops and the BlackBerry, which make electronic work easily portable. p. 110 In 1998, fathers averaged 48.3 and mothers averaged 38.5 hours of paid work activities per week (up 5% and 4% from 1992). p. 111 Collective agreements can provide stated work conditions, a formal grievance process, joint governance committees, consultation processes, and detailed job descriptions.

Social Determinants Chapter 8Improving Work p. 114 Even as we try to understand the linkages between working conditions and health, social and economic conditions are being transformed. p. 114 New forms of collective inquiry and dialogue between researchers and nonresearchers are needed to stimulate understanding and action. p. 114 *W+orkers possess valuable knowledge about their work conditions p. 115 Longitudinal studies show that workplace exposure precedes ill health outcomes.

p. 116 Research is also needed to better understand the cost of unhealthy working conditions. Note: This cost becomes an asset in a fully privatized health care system p. 116 Status quo policy responses of rolling back regulations has added to the unhealthy context of work environments. p. 117 See chart 8.1 for workplace health dimensions. p. 118 See box 8.1 for discussion of flexicurity policy approach in Denmark. p. 119 Should we accept that there may not be enough paid work for all, and focus instead on income security and community needs?

p. 119-120 Income security could mean that workers can refuse unsafe and underpaid work, and would have a say in work conditions and arrangements. p. 119-120 Income security would not necessarily reduce rate of bad jobs going to women and people of colour. p. 121 *W+orkers need the opportunity to choose and engage in work that fits with their desires, interests, and needs. p. 121 Redesigning work collectively would increase capacity and participation, and lead to better health. p. 122 We need to learn from the failure of health promotion approaches, and take a SDH approach.

p. 122 We need to acknowledge the constraints under which policy-makers function. p. 122 We can work through healthcare coalitions, as well as social coalitions. p. 122 People know what makes them and their communities healthy or sick.

8. How does violence affect our health? What are some of the forms of violence that affect people living in Canada, including people who have recently arrived?

Health Inequities Chapter 11Violence & Status p. 221 To track health inequities, we must consider immigration status (or non-status) and the different provincial and territorial health frameworks. p. 221 We define structural violence as the physical and psychological harm inflicted on these women by the socio-economic inequalities intrinsic to Western capitalist economic and political structures. p. 221 In this analysis, the violence that is exercised by the state when there is a lack of access to health and social services is deemed inadvertent...

p. 222 Health and social services policies do not take into account the range of contexts through which people migrate (refugees, trafficked human beings, temporary workers, and sponsored family members) nor their differential legal status when they get here. p. 222 People coming after 1990 havent done as well as people migrating before 1990. p.223 A significant number of immigration categories can be considered precarious in that they fail to confer the permanent right to remain in Canada and/or they are dependent on a third party such as a spouse or employer.

p. 223 In 2007, Canada admitted 797,932 temporary residents to 236,758 permanent residents. p. 224 If one conceives of health as a key human rights issue, lack of access to this is a form of systemic violence. p. 225 Women with precarious immigration status have little recourse against violence. p. *P+ersons without permanent resident status suffer from systemic discrimination in three fundamental areas: the right to family reunification, the right to non-discrimination in the provision of government benefits and services, and the right of workers to organize and bargain collectively.

p. 228 The recruitment of migrant workers is a central strategy of neoliberalization, yet the state presents migrants *individually and collectively+ as a problem. p. 230 People who exploit people with precarious status use tactics of abuse and manipulation. p. 231 Canada chooses women with precarious status as potentially permanent immigrants, but on the other hand, they live a trial period, sometimes indefinitely, with this status as temporary workers or dependents. *The systemic privilege of northern European immigrants has been built on assurances of citizenship and recognition of credentials, among other factors+

Health Inequities Chapter 14Intersectionality & PTSD p. 276 *T+rauma is not a monlithic phenomenon; instead, social location directly and indirectly influences the nature of trauma, the interpretation of the experience, the responses of others, and the personal and/or social resources available for responding to the trauma. p. 276 *W+e argue that the person-centred focus of the stress-response framework serves to decontextualize and depoliticize the experiences of women.

p. 200 Within this context, oppression refers to a process and an outcome whereby power exerted within political, social, environmental, and interpersonal relationships intersects to create advantages and disadvantages for psychological well-being. p. 283 The severity of impact of an given trauma on womens mental health is mediated by interpersonal stressors and resources. p. 283 Although the context of captivity *war v. abuse+ differs, tactics used by perpetrators, including force, intimidation, and manipulation to gain power and control over their victims, are almost identical.

p. 283 *F+or many women, the experiences of trauma enduring.

are multiple, overlapping, and

p. 284 Over their lifetimes, women and girls are more likely than men and boys to experience assaultive and psychological traumas, which, in turn, increase their risk for developing PTSD. Note: If responses to and interpretations of abuse are major factors in PTSD, we must understand gender ideology as a central risk factor. A focus on perpetrators justifications also highlights the role of gender ideology. Finally, binary gender ideology erases trans people, who also experience gender- based violence (Namaste, 2000).

p. 285 Intersectional approached to PTSD assign primacy to agency, which refers to peoples capacity for appraising and assigning meaning to their life circumstances, making meaningful choices, and engaging in activities that create personal, social, and political change. p. 288 *A+ccess to social supports and resources may influence PTSD symptomology in multiple ways including enhancing safety, symptom resolution, and re-establishing social network and family routines.

Health Inequities Chapter 15Trauma & Violence p. 295 How might health services better meet the complex needs of Aboriginal and nonAboriginal women marginalized by poverty, racism, and colonialism. p. 301 When media and policy frameworks foreground drugs, addiction, and sex work individual people themselves are constructed as the problem. p. 301 An overwhelming shortage of resources and services leads healthcare agencies to compete with each other to get services for their own clients.

p. 302 *A+n intersectional perspective prompts us to scrutinize taken-for-granted assumptions that categorize particular neighbourhoods as essentially destitute inner cites are often cites of activism, anti-poverty movements, and organizations that provide safe spaces for women such as social housing, shelters, and transition houses. p. 303 *B+iomedical perspectives in health care *tend+ to view issues such as poverty, violence and trauma, addictions, and chronic pain as fairly separate entities. p. 303 *P+overty gives illicit drug use in inner cities its public character.

p. 304 *T+he assumption that addictions can be treated in isolation from the wider contexts of peoples lives is perpetuated by the process of diagnosing and referring patients for addiction treatment p. 304 Thus, women are supported to contend with their addictions but not with the effects of trauma, ongoing exposure to violence, chronic pain, and the consequences of living in dire poverty.

p. 304 *N+on-pharmacological approached to pain management, strategies for addressing the violence and trauma, and associated grief and loss that often underpin chronic pain receive less attention.

p. 306 Residential school healing programs, mental health services (other than psychiatric services, which are very limited), dental care, and violence prevention are not viewed as eligible core-funded programs by the existing funding structure. p. 306 Attending to womens needs for safety begins with acknowledging that most of the women who use the health centres have experienced violence, historical and/or emotional trauma, and often childhood sexual abuse; this underpins concerted efforts to ensure that the spaces created inside and outside the health centres are safe for women.

9. What some of the colonial policies and practices of the Canadian state toward Aboriginal people? How do these policies and practices affect Aboriginal communities and Aboriginal peoples health?

Health Inequities Chapter 2Indigenous Health p. 54 *C+olonial constructions of indigenous identity, principally for the purpose of managing Indians, translated into significant divides between indigenous people and into differential abilities to access health care or support services that could contribute to better states of wellbeing. p. 56 *C+olonization plays a significant role in determining how, for instance, education is accessed by indigenous people, how income is allocated, or even how a person can access social support networks

p. 57 *W+hatever the nature of the disadvantage, it is often exacerbated due to twentyfirst century antiindigenous racism p. 58 Indigenous people were displaced differentially across Canada; treaties were signed in some areas, whereas vast geographies were left untreatied, and reserves were allocated differentially depending, for instance, on the value attributed to the land by colonial settlers. p. 60 The Indian Act of 1876 was created to control and manage reserves, lands, money, and property of Indians in Canada. The Indian Act is still in force today, for the same purposes.

p. 62 The management of residential schools was contracted out to different churches by the colonial government, and then the federal government.

p. 63 *I+f the United Nations Human Development Index were applied to indigenous peoples living on reserve, Canada would rank sixty-eighth to eightieth in the world. Note: This reality has been taken up as Third World, or with the concept of Fourth World p. 65 Jurisdictional issues between federal and provincial governments leave many First Nations people caught without health-related benefits and life-saving interventions (post-2000 NIHB v. community-based services).

p. 66 *U+nderstanding colonialism as a fundamental determinant, in conjunction with the other determinants, can provide one means of explaining and understanding the state of indigenous peoples health in Canada today. Social Determinants Chapter 19Aboriginal Health p. 281 In 2006, 1.2 million Canadians reported Aboriginal identity (an under-estimate as many reserve communities were not included in the census). p. 282 Note: Canada, the US, Australia, and New Zealand were the only countries to refuse to sign the UN Declaration on the Rights of Indigenous People in 2007. Canada signed on in 2010, perhaps as a way of diverting international bad opinion about the Alberta tar sands.

p. 286 The Constitution Act of 1867 and subsequent Indian Acts legalized the removal of First Nations communities, which had signed treaties, from their homelands to reserve lands that were controlled by the Government of Canada on behalf of Indians. Note: This is the system still in place today. This is also the system that white South African politicians used as a model when they created the Apartheid system in 1948. p. 289 Official federal presence in Inuit communities began in 1903. p. 289 Approximately 100 residential schools operated in Canada from 1849-1983.

p. 290 Mtis children were excluded and/or barred from attending community schools set up for the children of European colonists. p. 293 A BC study showed an inverse relationship between youth suicide and community systems that were community-controlled p. 293 Environmental health risks are clearly linked to environmental degradation through mostly non- Aboriginal commercial exploitation of traditional lands. p. 295 FNIHB has a strategy to transfer autonomy and control of health programs 279 out of 609 communities have signed transfer agreements.

p. 296 The Aboriginal Health and Wellness Strategy uses an Indigenous model of healing and wellness to deliver health services and programs in Ontario.

Second Opinion Chapter 7Aboriginal Health p. 122 The population chart shows that the highest number of Aboriginal people in Canada live in Ontario, while the highest percentage of Aboriginal people per province/territory is in Nunavut. Note: Nunavut has its own prime minister. p. 126 Both on- and off- reserve First Nations people reported lower rates of weekly drinking than the rest of the Canadian population. p. 128 Aboriginal people are disadvantaged on every social determinant of health.

p. 103 There are 100 Aboriginal communities under a boil water advisory. p. 131 Grocery bills in remote communities are more than twice the cost as they are in cities. p. 131 To accommodate colonial expansion, Aboriginal people were forced off their land onto reserves to make room for a new economy based on timber, minerals, and agriculture. p. 132 When the Indian Act was amended in 1884, residential school (operating since 1849) became mandatory for status Indians under 16. p. 134 Healing can be seen as a process of decolonization.

10. How does the capitalist economy affect our health? Does economic equality make us healthier?

Social Determinants Chapter 3Wage Inequality p. 42 In 2005 the mean family income in Canada was $70,300, while the median family income was $57,700 p. 43 In 1981 there was a 25:1 ratio between the market income of the richest 10% and the poorest 10%; by 1997, that ratio was 109:1 p. 45 The gap widens during both recessions and recovery periods p. 46 The apple shape distribution of market income has hollowed out

p. 46 The size of the middle class, relative to other income groups, decreased by 25 percent over the last 25 years. Note: If more Canadians than ever have, or are getting, an education, yet the middle class continues to shrink, what outcomes can we expect, individually and collectively? p. 48 Transfers and taxes (or redistributive factors) have an equalizing effect as they raise the incomes of those at the bottom (through transfers) and lower the incomes at the top (through taxes).

p. 49 This process drops the income ratio to 10:1

p. 49 Remember that the causal factor for income inequality is wages and incomes, factors that are under the responsibility of employers and corporations. p. 50 The top 1% makes just over half a million a year; the top 0.1% makes 2.5 million, while the top 0.01% makes over 8 million. Note: In Canada, this is about 3000 people; perhaps at Occupy we should have said We are the 99.99%! p. 50 When we measure wealth (assets minus debts), we find that the richest 10% has $1.2 million, while the poorest 10% owes $10,000.

p. 51 Note: If we look at 2005 net worth data, it seems that the top 30% own the equivalent of a home ranging in cost from 220,000 to 1.2 million, while the bottom 70% do not! p. 52 Income inequality is racialized, destitute, female, and young. p. 52 *M+ore than 40% of families derive at least 10% of their income from government transfers p. 52 More than 30 percent of Canadians were poor at some point between 1996 and 2001 p. 52 Trying to explain the income gap between white and racialized Canadians on average, people of colour earn 30% less than white Canadians

p. 53 White immigrants earn 22% more than immigrants of colour; 44% of immigrant men have university degrees, while only 22% of Canadian-born men do; all immigrants have shown competency in one of the official languages p. 54 This leaves racism as an explanation. When one looks beyond this surface image *of Canadian diversity+, one finds a strong legacy of racism, land theft, colonization, occupational segregation, and even slavery. Note: We must look at how racist ideology has led to a readiness to accept the neoliberal gutting of stable, decent paying jobswe have yet to see public outcry

p. 54 Women make 62% of mens incomes. If we look only at those in full time employment, women make 71% of mens incomes. p. 57 That is job of social movement organizations and coalitions *to+ select one or two specific initiatives for the base for a campaign. Note: one example has been the effort to raise the minimum wage in Ontario p. 57 We must proclaim that the market fails more and more of us at an accelerated pace, resulting in a growth of both absolute and relative inequality.

Social Determinants Chapter 4Income and Health

p. 62 Two limitations of income and health correlation studies are ecological fallacy and reverse causation. p. 63 A 2000 study found no relation between income inequality and mortality in Canada, but a strong relation in the United States. p. 63 A 2003 study found that income inequality was associated with poor self-reported health in Toronto, but not with chronic conditions or distress.

p. 63 Consequently, the association between income inequality and health remains a subject of debate. p. 63 *I+ncome has been associated with low birth weight; injury-related mortality developmental problems such as hyperactivity, psychosocial problems, delinquent behaviour, and delayed vocabulary development, among others. Note: that injuries can be addressed with rental regulation, neighbourhood development, and workplace safety; and that developmental problems are socially constructed, yet understood as biological characteristics of the poor

p. 63 Other researchers have linked poverty to obesity, asthma, and health service utilization in children. p. 64 For most causes of death, differences in mortality have diminished over timeexcept for suicide rates in women and girls. p. 67 A Quebec study found that mortality rates differ depending on level of deprivation. This is true for circulatory system disease, respiratory, accidental, and tumour mortality.

p. 71 Three theories explaining why income inequality affects health: 1) The rich exert pressure to reduce public spending; 2) inequality diminishes solidarity; and 3) inequality leads to frustration p. 72 In 2002, the government of Quebec unanimously passed Bill 112, a law to combat poverty and social exclusion. This law is unique in North America. Social Determinants Chapter 5Precarious Work p. 75-6 Some concepts: knowledge economy; internal labour market; and false selfemployment p. 77 *S+ecurity involves a sense of well-being or control, or mastery over ones activities and development, as well as the enjoyment of certain self-esteem. p. 77 *H+istorically speaking, employment standards, unionization, and unemployment insurance came about as a result of workers struggles

p. 77 Today only about one out of every two workers is eligible for employment insurance p. 78 Globalization and the international division of labour have contributed to the displacement of investment and jobs toward developing countries Note: The reason for this stems from a fundamental feature of capitalismin order to address the falling rate of profit, manufacturing capitalists must squeeze more surplus value from workers, giving them ever dropping wages in return. Capitalists have relied on global inequalities in standards of living and wages in order to extract a higher surplus value to offset the falling rate of profit.

p. 78 To reduce insecurity, we must either reduce job insecurity, or increase unemployment benefits. Note: Neither approach is viable as long as our overall economic framework remains capitalist. Job insecurity increases as capitalists seek profit returns on their investments, and benefits are slashed as governments reduce social spending, in part to keep these wages low, to promote growth. p. 78 The feeling of insecurity rises in countries with higher levels of education. p. 79 Only half of employed Canadians have one full time job that has lasted six months or more.

p. 81 In 2000, 12% of women and 19% of men were self-employed; 27% of women and 10% of men worked part time. p. 81 Laissez-faire states have left responsibility for (in) security with the individual; conservative states have intervened by strengthening state and family authority; social democrat states have reduced insecurity by controlling capital import and export, and by offering employability programs. p. 82 *I+n North America, there is more emphasis on passive measures such as workfare.

11. What might medicine look like if it were organized based on human need rather than capitalist imperatives? How might our ideas of health and illness change if we base our society on equity?

Second Opinion Chapter 9Medicalization p. 169 Medicine continues to play a key role in medicalization; however, other forces, such as the pharmaceutical industry, consumer groups, biotechnical discoveries, and health insurance are important engines of medicalization. p. 169 Is this medicalization due to an actual increase in medical problems or to better reporting? Or is it that some aspects of life and behaviour that once were considered normal are now subject to medical diagnosis and treatment?

p. 170 The manifestation of certain psychological conditions is not the only or indeed a necessary prerequisite for contact with institutionalized medicine. For example, individuals identified as potential deviants from medical (and social) norms may be viewed as being at risk for some types of illness or deviance and may be subject to medical surveillance in the name of preventing or reducing the so-called risk behaviour. p. 170 The medicalization thesis posits that physical conditions do not, by their nature, constitute illness; rather, they require identification and classification, which entail subjective and value-laden considerations.

p. 171 *M+edicalization can also confer certain benefits, including legitimation of the conditions as real rather than imaginary; access to the sick role; and access to insurance. p. 171 *M+edical categories are increasingly applied to all parts of life at the same time, people have internalized medical perspectives and actively seek or demand medical remedies. p. 172 Medicalization occurs at the conceptual, institutional, and interactional levels. p. 173 In the 1990s, the largest ADHD support group joined with the pharmaceutical company that makes Ritalin to extend the diagnosis to adults.

p. 173 The emergence and dominance of a medical approach to madness (later to be defined as mental illness) began in the late eighteenth century. p. 174 Psychiatry seeks to locate a pathological basis within the individual for such deviance and views certain types of behaviour as evidence of addiction, syndromes, conditions, personality disorders, or other mental illnesses. p. 175 Unlike confinement in other custodial institutions, commitment to an insane asylum entailed neither a trial, a fixed term of internment, nor the legal protection associated with criminal proceedings.

Note: Consider how this legal exception for the insane has extended to criminalized/pathologized groups such as youth in group homes, and terrorists p. 175 Mental institutions also play a role in wider public policy and in the regulation of subpopulations that are identified as problematic. p. 176 The rise of psychoanalysis expanded the reach of psychiatry to include problems with everyday life, as well as insanity. p. 177 Psychiatrists ability to identify, diagnose, and treat mental illness is contested by other disciplines that are concerned with human relations or social problems

p. 177 Some social movements, consumers, and occupational groups, such as teachers, are also involved in normative workthat is, identifying problematic behaviour and proposing medical, including psychiatric, intervention to achieve normality. Examples include AA and NAMI Note: The Schizophrenia Society in the Canadian context. p. 178 Mothers also stated that their decisions to medicate their children *for ADHD+ were the direct result of indirect school pressure, such as constant phone calls and questions as to whether their children were still on medication.

p. 180 *T+he stereotype of the hysterical woman remains pervasive, and behaviour that in the past may have resulted in a diagnosis of hysteria may today be diagnosed as either schizophrenia, a personality disorder, or PMS. p. 180 *T+he medicalization of male aging, baldness, and sexual performance is rooted in a masculine identity that embodies physical strength and energy.. and sexual vitality. p. 183 De-medicalization did not mean that gay men were no longer subject to discrimination or were no longer viewed as deviant.

Second Opinion Chapter 12Medical Dominance p. 230 How did medicine develop, and how did it achieve such dominance? p. 232 During the Renaissance *p+hysicians were those who had graduated from a school of medicine, and they provided diagnosis and treatment to the wealthy. Surgery, however, was practiced mostly by barbers and had a lower status Apothecaries, the early pharmacists, dispensed herbs and spices and in the countryside sometimes acted as physicians.

p. 233 During the nineteenth century, *a+long with medical discoveries, there was also a growing interest in social medicine, or what is now called public health. p. 233-5 There are five assumptions of allopathic medicine, as identified by Pat & Hugh Armstrong: the determinants of illness are biological; the body is like a machine and different specialists can treat different parts; health care exists to cure illness and disability; medicine is scientific; and the doctor is the expert. p. 235 In 2006, doctors comprised fewer than 12% of the total healthcare professional workforce

p. 236 Physician dominance is institutionalize through procedures, its education, and self-regulation.

professional control over licensing

p. 236 Doctors control access to non-medical benefits; they have authority over other health professionals; they control access to therapies through the referral process; they set professional standards; and they control medical school curriculum. p. 238 Historically, the consolidation of medical education in universities meant entry was restricted to those of higher class origins. p. 238 Medical power in Canada was consolidated between 1918 and 1962.

p. 238 Doctors strengthened their connections to elite groups and the state while absorbing or subordinating other health-related professions. p. 240 Challenge to this dominance came in the form of socialized medical care. The federal government passed the Medical Care Act in 1962. Doctors have resisted the socialization of medical care through strikes in 1962 (in Saskatchewan) and 1986 (in Ontario). p. 241 Along with the rise of health management came the professionalization of other health occupations. p. 242 There are internal conflicts-- the Medical Reform Group opposed extra billing in the 80s.

p. 242 People today have higher levels of education and are better informed about health issues. p. 243 This demystification, along with media coverage of medical error, has added to public skepticism p. 244 Medical schools now have much greater diversity, and a female majority, yet students are still disproportionately from wealthier families, and Black and Aboriginal communities are still under- represented. p. 246 Medical school curriculum does not focus on public health promotion. p. 247 Public health promotion in Canada still takes an individualized focus.

p. 249 PHAC was created in 2004 after the SARS outbreak, with a focus on healthy living, prevention and control of infectious and chronic illnesses; health and water safety; and emergency preparedness. p. 250 An individualist model had widespread support because it makes governments look authoritative and active while at the same time it avoids confrontations that might be politically costly.

Social Determinants Chapter 20Business & Politics p. 305 There is a tendency to cite economic factors e.g., lack of funding, as if the economy was some inexorable or omnipotent force that dictated social outcomes.

p. 305-6 Our GDP has increased by 75% over the past two decades, while social spending has decreased. the country is now far richer and could have sustained or increased expenditures on social programs.

p. 307 *T+he words of academics may have political impact only when they are championed by a think tank and passed to on the the mass media, prompting us to ask who sponsors the think tanks and who owns the media. p. 307 Historically, *r+eforms and concessions were made not only to foster capital accumulation but to maintain the legitimacy of capitalist rule. p. 307 The Canadian state provided financial and material infrastructure for business, and helped to raise the qualifications and reduce the expectations of the labour force, as required.

p. 308 The state, as a terrain of political struggle has developed two systems of representation: political parties and interest groups A plurality of groups was preferable in their eyes to polarization between classes p. 308 By 1975, concerns about an excess of democracy led corporate leaders to call for centralizing *of government+ authority and reducing its susceptibility to democratic inputs from citizens p. 309 Prominent right-wing think-tanks include the Howe Institute, and the Fraser Institute.

p. 309 Business associations include Canadian Bankers Association, Canadian Chamber of Commerce, and Canadian Council of Chief Executives. p. 310 Abstract discussions about re-structuring can lose sight of the political actors. p. 310-1 The CCCE formed to combat public concern over corporate welfare bums. Through consolidating their lobbying position they set the boundaries or constraints on what governments can do. p. 311 In the 1990s, the federal government had such faith that trade would drive the economy that the government abandoned its traditional tools of industrial and regional development

p. 312 Integrating more closely with the Unites States could not fail to put further pressure on Canadas frail social safety net and further exacerbate inequalities in income, wealth, and power. p. 312 If citizens are to reassert their power and restore democracy, they will first have to raise public awareness about the threat of corporate control.

p. 314 Medicare offers a fine modellets add pharmacare, child care, and home care as well as free university education and public transit.

12. What political interventions are needed to improve the health of people who live in Canada, especially those who are socially disadvantaged? What are some challenges to organizing for change?

Social Determinants Chapter 24Policy Action p. 364 While positivist science has led to impressive advances in the natural sciences, its application to the fields of the health sciences and other areas of social inquiry has been problematic. p. 264 Positivist health and social science also avoids analysis of the abstract, implying the study of the underlying economic, political, and social structures of society are beyond its analytical and methodological scope.

p. 364 This leads to researchers and workers being unwilling to make what are termed normative judgments as to what should be as opposed to describing what is. p. 364 *I+ndividualized, localized, desocialized, and depoliticized *approaches to health are+ congruent with conservative and neoliberal political ideology, whereby social problems such as unemployment, poverty, and racism are framed as individual rather than societal issues. p. 365 Individualism in health specifies the cause of the health problem residing within faulty biomedical markers, specific individual motivations, and risk behaviours that are somehow under individual control.

p. 365 A historical materialist paradigm for understanding health *attempts+ to illuminate how various modes of production, especially capitalist societies, influence the distribution of economic, social and political resources within the population, thereby influencing health. Note: A historical materialist approach also focuses on the ways in which individual and collective ill health arises from exploitation and resources expropriation. p. 365 A conservative form of the welfare state arose whose main concern was with reducing unrest and promoting a modicum of security for citizens.

p. 365 In Scandinavia, the social democratic welfare promotion of equality and human rights

state arose, which saw active

p. 366 The third form of the welfare statethe liberal is the weakest of all and Canada falls within this group Within liberal welfare states, liberty and its close neighbour, selfdetermination, become available only to a narrow band of the population. p. 366 Neoliberalism refers to the dominance of markets and the market model. Tenets are: markets are the most efficient allocators of resources; individuals are autonomous; and competition leads to innovation.

p. 367 Canadian society is moving more and more toward that of the most extreme liberal welfare state, the United States. p. 367 Pluralist, materialist, and public choice are three models for understanding how policy change happens. Pluralists assume that policy-making is a democratic process where better ideas, and persuasive arguments win out. If we take this approach, it would seem that we would need to educate policy makers on the social determinants of health in order to affect change. However, the authors note that their extensive research and recommendations have not been heeded.

p. 368-9 A materialist approach to understanding policy change notes that governments in Canada enact policies that serve the interests of economic elites. These policies include deregulating labour, lowering corporate and individual income tax, opposing unions, cutting income support programs, and de- funding social programs. p. 369 *E+xtensive cuts have been made to public housing, education, mental health, and violence against women services. Promises to fund housing and child care programs have been broken.

p. 369 Economic interests are able to influence government policy through their ability to shift investment capital from location to location *through raising+ borrowing rates for debt-ridden jurisdictions and through backing political candidates. p. 369 The materialist model suggests organizing the population to oppose and defeat the powerful interests that influence governments to maintain poverty. p. 369 The public choice model of understanding policy change suggests that policy makers balance stakeholder interests as well as their own interests.

p. 370 This approach suggest it would not be in policymakers interests to focus on the SDH, as people who experience poor SDH are neither organized nor influential. p. 370 Faced with such formidable policy options, many *health and service workers+ turn to community development as a means of improving health and well-being. While this can only lead to the most incremental social changes, it does keep workers close to their communities, and well informed about their needs, struggles, and triumphs.

p. 370-1 Why do affected communities seem to accept the current social and economic situation? 1) Canadians are borrowing to compensate for this loss 2) No political leader wants to reveal how the market is failing the majority of its citizens 3) It serves the elite for low- and middle-income earners to point the blame for their social ills at other marginalized groups. These groups include immigrants the welfare poor and even the unionized workers p. 371 4) Through *self blame+ we become agents in our own marginalization, a process identifies by Gramsci as hegemony.

p. 372 5) When coupled with the ideological strain that individualism places on ones psyche (that these problems are mine, and it is my responsibility to dig myself out of this hole), low wage workers suffer psychologically and materially. p. 372 6) Political leaders assume that the world works for the majority in much the same way that it works for the privileged. p. 373 7) Despite the fact that only 5 percent of individuals have incomes of $89,000 and up the myth of income mobility is held out in front of us like a carrot

p. 374 We need strategic ways to force political decision makers to reject the voices of the powerful and accept those of the marginalized. p. 374 We should also support movements that create more enduring alternatives (such as proportional representation, progressive media outlets, political reform), and citizen education that yields an engaged citizenry willing to get involved in the political process.

Health Inequities Chapter 17Influencing Policy p. 334 The authors conducted focus groups with equity-focused policy makers to find out how their work is organized and influenced. p. 335 *T+he relationship between evidence and policy can take many forms p. 335 The importance of the political, structural, and values context became increasingly clear as our team, comprising researcher and provincial policy makers, began working together.

p. 335 *W+e elected to use ethical inquiry within a qualitative participatory methodology to explore the perspectives of health and social service policy makers.

p. 337 For many, equity was primarily focused on access to health care rather than on equitable health outcomes. For others, access to health care was understood as an issue of equalitythat is, having equal and available services in all communities. p. 337 This predominant focus on equality of access is congruent with the bureaucracy and proceduralism that evolved in the twentieth century welfare capitalist system.

p. 339 The emphasis on equality and equity of access to health care in policyrather than equity in relation to social determinants of health was consistent with the importance of the Health Care Act in Canada... *which provides+ access to hospital, physician, and surgical-dental services. p. 339 Some participants argued that notions of equity and social justice were tacitly avoided in government. p. 340 Participants noted that their job was to support the elected minister, not to champion justice per se

p. 340 The influence of the broader economic system was readily evident in often-used phrases such as value for money, biggest bang for the buck, the economic argument, and making a business case p. 341 Health as disease reduction can be addressed by health ministries, while addressing social determinants of health would require collaboration across ministries. p. 341 Although policy makers saw equity as relevant, and possibly a goal of policy, it was not the primary goal. Rather, they described working continuously to support politicians and to manage public outcry. *They+ emphasized how powerful such opinions were in shaping policy decisions.

p. 341 Evidence was seen as useful insofar as it aligned with multiple other factors. These factors Included media clippings and other proxies for public concern p. 342 Evidence was sought after public opinion turned toward a particular issue. p. 342 This approach leads to policies dealing with single issues as they arise in the media. p. 343 *W+e end up with a series of work-arounds without having that systems overview. p. 344 Policy makers referred to whole system approaches as more deliberative, integrated, intersectoral, and preventative,

p. 344 Policy makers noted researchers could help them get the biggest bang for their buck through policies that would have broad and multiple effects. p. 345 If researchers connect with citizens, advocacy groups, and policy-makers, they might create public outcry through multiple stakeholders and *offer+ evidence produced through intersectional analyses at each turn.

p. 346 Further, researchers might identify where value with those people/ opportunities.

for social justice is held and align

Health Inequities Chapter 18CRIAW This chapter examines the shift from a gender-only focus to an intersectional focus of the Canadian Research Institute for the Advancement of Women. p. 350 Although feminist researchers often look at governance, they do not as often look at governance within feminist organizations. Governance includes policies, procedures, and regulations around the election of boards, which influence the appearance of bodies that occupy these seats,

p. 351 CRIAW had a history of championing gender- based analysis in policy (GBA). p. 351 CRIAW was dominated by franco-anglo and class tensions. Due to a representational system that mirrored federalism, eastern Canada was overrepresented. p. 353 As a non-profit, CRIAW is governed by acts governing non-profitsthee acts reinforce hierarchical electoral systems and top-down colonial administrative bureaucracy. p. 354 Status of Women Canada demanded that CRIAW demonstrate greater productivity and accountability.

p. 354 CRIAW was forced to update its mandate and framework in order to stay relevant. p. 355 As new directions were identified, people invested in the old gender-based, whitefocused model left. p. 356 It fell to a small group of minority women to do the research, provide the contacts from their own networks, and also do the writing and editing. p. 356 This was part of the push to provide deliverables. p. 357 Aboriginal women wanted the organization to move past the researcher subject/object divide.

p. 357 Others critiqued a citizen focus that obscured refugees, whose identity categories were only meaningful if they had a nation-state to formally recognize them. p. 358 CRIAWs process of developing an intersectional approach did not fully recognize the intellectual contributions of its minority women. p. 357 the Canadian womens health movement has made advances in improving the health standing of mainstream women, but it has also, paradoxically, left those most marginalized behind. p. 357 It is rare to find minority women as authors, researchers and analysts of their own reality.

Abramson, Zelda (2012) Chapter eightEnvironmental links to health, in John Germov & Jennie Hornosty (eds.) Second Opinion: An Introduction to Health SociologyCanadian Edition (Toronto: Oxford University Press) pp. 142-165 McIntyre, Lynn & Krista Rondeau (2009) Chapter thirteenFood insecurity, in Dennis Raphael (ed.) Social Determinants of HealthSecond Edition (Toronto: Canadian Scholars Press) pp. 188-204 Tarasuk, Tara (2009) Chapter fourteenHealth implications of food insecurity, in Dennis Raphael (ed.) Social Determinants of HealthSecond Edition (Toronto: Canadian Scholars Press) pp. 205-220 Dossa, Parin & Isabel Dyck (2011) Chapter twelvePlace, health, and home: Gender and migration in the constitution of healthy space, in Olena Hankivsky (ed.) Health Inequities in Canada: Intersectional Frameworks and Practices (Vancouver: UBC Press) pp. 239-256 Shapcott, Michael (2009) Chapter fifteenHousing, in Dennis Raphael (ed.) Social Determinants of HealthSecond Edition (Toronto: Canadian Scholars Press) pp. 221-234 Bryant, Toba (2009) Chapter sixteenHousing and health: More than bricks and mortar, in Dennis Raphael (ed.) Social Determinants of HealthSecond Edition (Toronto: Canadian Scholars Press) pp. 235-249

Work
Tompa, Emile, et al (2009) Chapter sixLabour market flexibility and worker insecurity, in Dennis Raphael (ed.) Social Determinants of HealthSecond Edition (Toronto: Canadian Scholars Press) pp. 88-98 Jackson, Andrew (2009) Chapter sevenThe unhealthy Canadian workplace, in Dennis Raphael (ed.) Social Determinants of HealthSecond Edition (Toronto: Canadian Scholars Press) pp. 99-113 Smith, Peter & Michael Polanyi (2009) Chapter eight Understanding and improving the health of work, in Dennis Raphael (ed.) Social Determinants of HealthSecond Edition (Toronto: Canadian Scholars Press) pp. 114-124

Violence
Oxman-Martinez, Jacqueline & Jill Hanley (2011) Chapter eleven An intersectional lens on various facets of violence: Access to health and social services for women with precarious immigration status, in Olena Hankivsky (ed.) Health Inequities in Canada: Intersectional Frameworks and Practices (Vancouver: UBC Press) pp. 221-238 Samuels-Dennis et al (2011) Chapter fourteenIntersectionality model of trauma and posttraumatic stress disorder, in Olena Hankivsky (ed.) Health Inequities in Canada: Intersectional Frameworks and Practices (Vancouver: UBC Press) pp. 274-292 Browne, Annette, et al (2011) Chapter fifteenAddressing trauma, violence, and pain: Research in health services for women at the intersections of history and economics, in Olena Hankivsky (ed.) Health Inequities in Canada: Intersectional Frameworks and Practices (Vancouver: UBC Press) pp. 295-311

Colonialism and health

De Leeuw, Sarah & Margo Greenwood (2011) Chapter two Beyond borders and boundaries: Addressing indigenous health inequities in Canada through theories of social determinants of health and intersectionality, in Olena Hankivsky (ed.) Health Inequities in Canada: Intersectional Frameworks and Practices (Vancouver: UBC Press) pp. 53- 70 Smylie, Janet (2009) Chapter nineteenThe health of Aboriginal peoples, in Dennis Raphael (ed.) Social Determinants of HealthSecond Edition (Toronto: Canadian Scholars Press) pp. 280-301 Hornosty, Jennie et al (2012) Chapter sevenCanadas aboriginal people and health: The perpetuation of inequalities, in John Germov & Jennie Hornosty (eds.) Second Opinion: An Introduction to Health SociologyCanadian Edition (Toronto: Oxford University Press) pp. 119141

Capitalism and health

Curry-Stevens, Ann (2009) Chapter threeWhen economic growth doesnt trickle down: The wage dimensions of income polarization, in Dennis Raphael (ed.) Social Determinants of HealthSecond Edition (Toronto: Canadian Scholars Press) pp. 41-60 Auger, Nathalie & Carolyne Alix (2009) Chapter fourIncome, income distribution, and health in Canada, in Dennis Raphael (ed.) Social Determinants of HealthSecond Edition (Toronto: Canadian Scholars Press) pp. 61-74 Tremblay, Diane-Gabrielle (2009) Chapter fivePrecarious work and the labour market, in Dennis Raphael (ed.) Social Determinants of HealthSecond Edition (Toronto: Canadian Scholars Press) pp. 75-87

Medicine and health

Anleu, Sharon & Jennie Hornosty (2012) Chapter nineThe medicalization of society, in John Germov & Jennie Hornosty (eds.) Second Opinion: An Introduction to Health Sociology Canadian Edition (Toronto: Oxford University Press) pp. 168-186 Hornosty, Jennie & John Germov (2012) Chapter twelve Medicine, medical dominance, and public health, in John Germov & Jennie Hornosty (eds.) Second Opinion: An Introduction to Health SociologyCanadian Edition (Toronto: Oxford University Press) pp. 230-253 Langille, David (2009) Chapter twentyFollow the money: How business and politics define our health, in Dennis Raphael (ed.) Social Determinants of HealthSecond Edition (Toronto: Canadian Scholars Press) pp. 305-317

Policy and health

Raphael, Dennis & Ann Curry-Stevens (2009) Chapter twentyfour Surmounting the barriers: Making action on the social determinants of health a public policy priority, in Dennis Raphael (ed.) Social Determinants of HealthSecond Edition (Toronto: Canadian Scholars Press) pp. 362-377 Vancoe, Coleen et al (2011) Chapter seventeenIntersectionality justice, and influencing policy, in Olena Hankivsky (ed.) Health Inequities in Canada: Intersectional Frameworks and Practices (Vancouver: UBC Press) pp. 331-348

Lee, Jo-Anne (2009) Chapter eighteenIntersectional feminist frameworks in practice: CRIAWs journey toward intersectional feminist frameworks, implications for equity in health, in Olena Hankivsky (ed.) Health Inequities in Canada: Intersectional Frameworks and Practices (Vancouver: UBC Press) pp. 349-362