The Major Determinants of Health

Roy Romanow, former premier of Saskatchewan, published a report in 2002 on the future of Canada’s health care system. At a speaking engagement, he offered the following tips for a long and health life:

1. Don’t be poor. Rich people live longer than poor people and they’re healthier at every stage in life.

2. Pick your parents well. Make sure they nurture your sense of identity and self-esteem and surround you with interesting stimuli. Prenatal and early childhood experiences have a powerful effect on later health and well-being.

3. Graduate from high school and then go on to college or university. Health status improves with your level of education.

4. Don’t work in a stressful, low-paid, manual job in which you have little decision-making authority or control. Poor jobs equal poor health.

5. Don’t lose your job and become unemployed. Unemployed people suffer from stress and isolation and can become poor – and remember what I said about being poor.

6. Be sure to live in a community where you trust your neighbours and feel that you belong. A civil and trusting community promotes health and life expectancy.

7. Live in quality housing, but not next to a busy street, in an urban ghetto or near a polluted river. Clean air, water and soil are vital to your health, as are the human-made elements of our physical environment.

Globe and Mail health columnist André Picard offered a similar list. He attributed it to Romanow, but it seems to have been inspired by the former premier's list instead:

1. Don't be poor.

2. Pick your parents well.

3. Graduate from high school or, better yet, university.

4. Don't work at a stressful, low-paid job. Find a job where you have decision-making power and control.

5. Learn to control stress levels.

6. Be able to afford a foreign holiday and sunbathe (with SPF 30).

7. Don't be unemployed.

8. Live in a community where you have a sense of belonging.

9. Don't live in a ghetto, near a major road or polluting factory.

10. Learn to make friends and keep them.

Good advice, but certainly hard to follow in some cases since we don’t necessarily have that much control over our circumstances. Indeed, if memory serves, that’s exactly the point Picard wanted to make.