Do great local minds think alike? Comparing perceptions of the social determinants of health between non-profit and governmental actors in two Canadian cities

Abstract

Cities are important sites for intervention on social determinants of health (SDOH); yet, little is known about how influential local actors, namely workers in municipal governments (GOVs) and community-based organizations (CBOs), perceive the SDOH. Capturing and comparing perceptions between these groups are important for assessing how SDOH discourse has permeated local actors' thinking--a meaningful endeavour as local-level health equity action often invokes inter-institutional partnerships. This paper compares SDOH perceptions between CBO workers in Hamilton, Ontario, with politicians and senior-level staff in GOVs in Vancouver, British Columbia, based on two studies with surveys containing identical questions on SDOH perceptions. Overall, there was high comparability between the groups in their relative ratings of the SDOH. Both groups assigned high levels of 'influence' and 'priority' to 'healthy lifestyles' and 'clean air and water' and lower levels to 'strong community' and 'income'. Given the importance of a shared vision in collaborative enterprises, the comparability of perceptions between the groups found here holds promise for the prospect of inter-institutional partnerships. However, the low rating assigned to more structural health determinants suggests that more work is needed from researchers and advocates to effectively advance a health equity agenda at the local level in Canada.