CPHA and the social determinants of health: an analysis of policy documents and statements and recommendations for future action.

Recently published reports have raised the Social Determinants of Health (SDH) to a level of prominence that makes it difficult for governments and health agencies to ignore. This commentary analyzes CPHA (Canadian Public Health Association) policy statements and positions dating from 1970 to the present to identify where these stand in relation to seven SDH discourses. We locate where CPHA stands on the SDH, appraise its role in the SDH debate, and propose actions to better position CPHA to address SDH. Our analysis indicates that CPHA has not only kept pace with developments in the field of social determinants, but has arguably been well ahead of its time. However, CPHA's response to the World Health Organization's Commission on the Social Determinants of Health shows a striking similarity to earlier commitments that have had limited impacts. We propose that CPHA consider analyzing some of the economic and political structures and justifying ideologies that have prevented its work in the public policy area from promoting public understanding and achieving public policy traction over the past 30 years. We also offer several steps that CPHA could take to reduce the gap between knowledge and action on the determinants of health in Canada.