The Determinants of Health in New Brunswick
- cdekleva1
- Feb 15
- 7 min read
Updated: Mar 30
I’m not only a healthcare professional in the province of New Brunswick- but I also work for the province of New Brunswick in the public health branch of our Department of Health. I know that the Determinants of health intertwine with healthcare in general but in public health they’re a pretty big deal. When I applied for my first job with regional public health years ago, I went looking for more information about the determinants of health and found many of the resources that I have referenced below.
Public health has its foundations in trying to prevent and control the spread of communicable diseases (Canadian Public Health Association, 2010). It comes from a place of population health, which is understanding that in order to provide care for someone you have to care for the whole person and in fact, the whole community to get to the root of achieving that mecca of wellness or desired definition of health.
The Health Canada website is somewhere I reference often in my work. I think I used it for that interview I spoke about above with regional public health, because it has lots of helpful information. Understanding the determinants of health means truly understanding that the WHO definition of health from 1948 needs additions to be completely representative of today (Constitution, 2025). Health Canada references the 12 determinants of health but also notes that you need to consider the social determinants of health when you are looking at the impact that these factors have on someone as an individual or on a population as a whole (Department of Health, 2018). In addition, it talks about the influence that health inequalities have on a person’s ability to be healthy (Department of Health, 2018). To summarize when you gather all of the factors that determine that sublime place of health- there are things you’re born with, things that happen to you, things that can be changed, and things that can’t (Department of Health, 2018).
The second resource I’ve included for you is from one of my favourite spots; The National Collaborating Centre for Determinants of Health (NCCDH, 2024). There are six National Collaborating Centres and the NCCDH is the closest to me based out of Antigonish, Nova Scotia. This might be why I like it so much, but it also has a lot of information that I relate to as a person. In the resource I listed from the centre we learn that the Canadian public health community continues to add additional information and change its perspectives based on what is happening around the country and the world (NCCDH, 2024). It states that “Determinants of health refer to the factors that influence the health of individuals, communities and populations. Determinants of health include individual characteristics (e.g., behaviours, biology, genetics, lifestyle) and social, economic, and physical environments, in addition to health care. While it is often used synonymously with social determinants of health, the term determinants of health is a broader concept that is not specific to the social justice roots of health inequities.” (NCCDH, 2024, p.2). It too incorporates and speaks about the other pieces that weigh in on how a determinant of health influences someone when it refers to health inequities and things like “structural, social, ecological, political, economic, and commercial determinants of health” (NCCDH, 2024, p.2).
My favourite part of this resource and why I think it resonates with me is that it uses the metaphor of a tree with its portion above ground and hidden roots below the surface to explain how public health action can impact health inequities (NCCDH, 2024). The work I do daily for the province seems to take all of this into account and we use this often in our work.
The third resource I’ve shared with you is an article I found on the Athabasca Library website. When I searched for determinants of health and it came up, I thought it really spoke to the whole concept of health. Written in 2023, it’s recent, and touches on the determinants of health in the context of mental health (Walker et al., 2023). It looks at mental health in students at a university campus in the United States and to determine how the various factors such as income, past adverse events, food security, housing, etc. influence this piece of overall health (Walker et al., 2023).
In the end the authors found that it would be helpful for educators at the university to understand what might be causing the rise in students being diagnosed with mental health issues, so they could examine and address how they could support them in the journey to feeling better once again (Walker et al., 2023). It’s not an article defining the determinants of health per se, but it touches on how important they are in shaping an individual’s health and how they participate and go through the rest of their life (Walker et al., 2023).
To find out more about New Brunswick, I searched our public facing government website to look at how we talk about the determinants, because I wanted to imagine being a member of the public trying to see what I could find.
Although my province is guided by the Health Canada website I mentioned (Department of Health, 2018) and the resources from the NCCDH (NCCDH, 2024), we also have a document about Health Inequities published in 2016 (Department of Health, 2016) and another about climate change from 2021 (Department of Health, 2021) that I was able to find when I searched the public website.
Priority determinants in New Brunswick involve a lot more of those additional pieces of health inequities that I referenced earlier (NCCDH, 2024). However, a few of the basic determinants of health that comes up over and over in the province are education and literacy and access to health services (Department of Health, 2018). We struggle with lack of healthcare providers to provide primary care so many people in the province are only able to access care when they have an urgent or emergent situation. This means that preventative care such as screening, or the conversations about health and wellbeing don’t happen because there is nobody to do it regularly and there is no time for these pieces of healthcare in the emergency room.
There is also a lot of discussion about education and literacy from building a curriculum that gets taught in the way it intended to and then making sure there are enough teachers and support staff trained to physically teach the subjects and then counsel students on matters if things don’t go as planned. The link in the determinants is seen because they are taught healthy behaviours at school, but that depends on the curriculum and the teacher. Up until recently the political party in power had some right wing beliefs and felt that education on sexual health, gender, etc., was something that should be done at home and not in the classroom. This left some people happy, and others upset. It tied into the piece tat not everyone has a parent or a safe adult who knows how or what to teach at home, and that this looks different based on culture, upbringing, etc.
In a province that has just over 800,000 people we depend on natural resources and industry to fund a large majority of our economy. In comparison to larger provinces and almost any other province in Canada the money we would have to spend on these important determinants of health would be less given there are less people to serve. When you factor health equity into the mix you see that New Brunswick’s median after tax income in 2023 is the second lowest in the country at $59,000 (Blair, 2024). Statistics Canada data in 2024 also shows that the number of persons over 65 living in the province of New Brunswick in 2024 make up 23.0% of the total population, which is the second highest group (Government of Canada, Statistics Canada, 2024). This lines up with one of our priority determinants given that nearly 200,000 people would be over 65 years of age and likely have more chronic health conditions. It's why I was pleased to see the New Brunswick material on health inequities on our website (Department of Health, 2016). The report is dated, but it's till valuable to know that we've been aware of our needs for some time.
This is all food for thought in the work that I do. New Brunswick has a lot of work to do and could likely learn a lot from some of the other provinces as well. It balances the structural determinant of politics in the mix of deciding what it values on any given day and I’ll be curious to see what the next few years bring with a change in leadership at the federal level.
References
Blair, N. (2024). Income Statistics in Canada. Made in CA.
Canadian Public Health Association. (2010). This is Public Health: A Canadian History-
Executive Summary. In Canadian Public Health Association.
Constitution. (2025). World Health Organization. Retrieved February 7, 2025, from
Department of Health. (2016). Health Inequities: A Report from the Office of the Chief
Medical Officer of Health. Retrieved February 12, 2025, from
Determinants of Health. (2018). Health Canada. Retrieved February 10, 2025, from
Department of Health. (2021). Understanding climate change and health implications: A
background report to New Brunswick’s Climate Change and Health Vulnerability &
Adaptation Assessment project.
Determinants of Health. (2024). World Health Organization. Retrieved February
10, 2025, from https://www.who.int/news-room/questions-and-
Government of Canada, Statistics Canada. (2024). Demographic estimates
by age and gender, provinces and territories: Interactive dashboard.
NCCDH. (2024). Let's Talk Determinants of Health.
Walker, D. O. H., Caridad Rabelo, V., Stewart, O. J., & Herbert, D. N. (2023). Social
determinants of mental health: the roles of traumatic events, financial strain, housing
instability, food insecurity, and commute time. Journal of American College Health,
72(9), 3591–3602. https://doi.org/10.1080/07448481.2023.2185454
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