Social Determinants of Health

This article argues for child welfare to be named a social determinant of health for First Nations and Métis peoples. For decades, First Nations and Métis children have been overrepresented in child welfare (CW) systems across Canada. Despite governmental and public awareness of the devastating impacts on Indigenous children and families from CW policies and practices, CW systems across Canada apprehend Indigenous children at alarming rates, and a significant number of Indigenous children are raised outside of their families, culture, and communities in non-Indigenous foster and adoption placements. This paper examines whether the state is fulfilling its mandate to be a “wise and compassionate parent” based upon a social determinants of health perspective. We consider specifically the impacts of foster home overcrowding, multiple foster placements, and the micro-level “day to day” experiences of Indigenous children and parents.

In this article, we propose the conceptualization of family structure as an important socially stratified grouping within a social determinants of health (SDOH) framework. We explore how family science literature supports this conceptualization of family structure through evidence of inequity in health outcomes across structurally diverse families that can and ought to be addressed; social stratification across family structures in which some family forms have greater prestige and power than others; and internalized, personally mediated, and institutional prejudices and discriminations that operate on the basis of these social stratifications. Ultimately, we contend that conceptualizing family structure as a socially stratified grouping within an SDOH framework can help enhance family science scholarship and assist family professionals in more effectively serving contemporary families.

On any single night, an estimated 550,000 people experienced homelessness in 2016 (U.S. Department of Housing and Urban Development, 2016). Research has shown that the well-being of both families and unaccompanied youth is greatly affected by the experience of housing instability and homelessness. The nexus between housing insecurity and child welfare has become more clear over time. Poorer physical health, mental health, and educational outcomes are just a few of the negative consequences that families and unaccompanied youth face. Families and unaccompanied youth facing the many obstacles tied to attaining and retaining safe and stable housing often become involved with the child welfare system, and those same housing obstacles later contribute to barriers for family reunification once involved with the child welfare system.

This issue is dedicated to exploring the issues of children with disabilities in the child welfare system, a population that is overrepresented in child welfare. Articles include an overview of the prevalence and population of children with disabilities in child welfare, evidence-based and promising practices for working with children with disabilities in child welfare, and innovative examples of collaboration and communication across systems.

Dr Calum Webb uses complex statistical analysis to unpack the data used within the Child Welfare Inequalities Project (UK) to share findings around the social gradient in interventions and how it differs in relation to both income inequality and ethnicity. He uses an intersectional analysis to share the implications of the findings for those working within the social care sector.

Sophie Howes from the Child Poverty Action Group (UK) offers an analysis of the policy context surrounding child poverty and its impact on children. She reflects on research on the impact of child poverty on children and shares policy recommendations for a potential way forward.

This full issue of The Future of Children is dedicated to understanding the ways in which cultural and social determinants impact the health and economic future of children.

The Total Environment Assessment Model for Early Child Development was developed for the World Health Organization’s Commission on the Social Determinants of Health to highlight the environments and experiences that influence ECD.1 TEAM-ECD builds on the bio-ecological model,2 developmental psychology,3 the concept of “biological embedding,”4 the social determinants of health,5,6 research regarding social relations in human society,7 and political economy.8 It features interacting and interdependent spheres of influence that are instrumental for ECD: the individual, family and dwelling, residential and relational communities, programs and services, regional, national and global environments, and civil society.

This resource offers both a background on social determinants of health, as well as a link to to view a webinar where public health leaders discuss how to shape equitable children's health outcomes. The topics in the webinar include: what are social determinants of health—specifically in relation to their impact on children, how the pandemic brought more attention to child welfare, how climate change might be exacerbating children’s health issues, what is happening at a federal and state level—and what can the individual do to support children’s health in under-resourced communities?