Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Social Work

Faculty/School

Lyle S. Hallman Faculty of Social Work

First Advisor

Bill Lee

Advisor Role

Thesis Supervisor

Abstract

The social determinants of health (SDOH) are the broad range of societal factors such as income and its distribution, education and literacy, (un)employment, health care, and so on, that contribute to the overall (aggregate) health, well-being and quality of life of our society as a whole (vis-a-vis, population health). Central questions in this thesis are: "Is political will a determinant of health?" and if so, "How is political will a determinant of health?" In responding to these questions this study analyzes a never-before-assembled Province of Ontario data set (1980 through 2000) rigourously operationalized as ten indicators of political will and seven SDOH policy development and SDOH outcome proxies. The case context of Ontario is used because during the 20 year period studied six regime changes occurred in the Province, each with very different ideologically-oriented governance mandates. Cross-correlation and exploratory factor analytic (EFA) techniques were used to analyze major relationships and identify statistical factors shedding light on how political will is a determinant of health. A three-factor outcome accounting for 88.9% of the total variance (r2) of political will as a determinant of health was produced. The resulting three-factor solution suggested that a social-economic governance capacity factor, a government ideology factor, and an SDOH outcomes factor connected political will to a party's capacity to govern, government ideology, and SDOH outcomes. The high variance accounted for in this study occurred because of the high quality of data used and the rigourous, meticulous and innovative methodology used to operationalize the data. Very strong relationships between political will and SDOH variables indicated substantive associations between these proxies. The resulting model provides compelling evidence that political will can be conceived of as a determinant of health. This study provides a compelling case for future research and has specific implications for progressive human services providers.

Convocation Year

2006

Convocation Season

Fall

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