Sleep and the social determinants of health

Influencing factors

There is a strong link between good-quality sleep and good health. No one chooses to sleep poorly. There are healthy habits and behaviours that will help you get better sleep, but these day-to-day behaviours are influenced by big-picture, systems-level factors far more than your day-to-day choices.

For example, making your bedroom sleep friendly is an useful step to good sleep; it's important that your bedroom is dark, quiet and comfortable. However, if you are poor and must share your sleep area with many family members or you can only afford to live in a neighborhood that is violent and noisy after dark, it will be harder to implement this very helpful strategy. Similarly, getting regular physical activity will help you fall  into sleep more easily and more deeply. However, this can be harder if your neighborhood's sidewalks are not well-maintained or it is not safe to go out for an evening walk.

The choices you make are affected by the choices you have.

The social determinants of health

There is a growing understanding that health is influenced by factors beyond the individual. Behaviours that contribute to health can be facilitated or hindered by conditions in society that are shaped by the distribution of money, power and resources. These conditions are called the social determinants of health (SDoH). They can create inequities so that some people are not as well equipped as others to achieve their optimal health potential.

Every person deserves the conditions in which they, and all people, can be healthy. These include equal opportunities for:

• Education
• Housing
• Employment
• Fair wages
• Access to healthcare
• Access to healthy foods
• Access to green spaces
• Safe work conditions
• Hopefulness
• Freedom from racism, classism, sexism, and other forms of exclusion, marginalization and discrimination based on social status

Income, housing, education, work conditions (job security and stress), social isolation and many other "big picture" factors are all strongly associated with sleep quality and they affect your ability to engage in other healthy habits.  

Investing in education, housing, better work conditions and other root causes of health (rather than only individual education) will improve the health of all, especially the health of the most vulnerable.

What can I do today to influence the social determinants of health?

The truth is, many people intuitively understand that there's more to health than individual responsibility. We experience every day how our circumstances and environment influence whether it is easy or hard for us to engage in healthy behaviours and be healthy.

We often write about the SDoH because we want to emphasize that since health is influenced by conditions beyond the individual, the approaches to improve health must go beyond individual strategies — they must also influence the society and environments in which we live. There are many ways you can impact the SDoH, from what you think, to what you say, to how you vote:

• Consider how your environment — in your home, at Concordia, at work — makes it harder or easier to be healthy and work to change those factors as well as your indivudual behaviours.
• Consider the SDoH in your daily life: when you write assignments, develop new projects at work, listen to the news or interact with others.
• Encourage decision-makers to create policies that support the health of Concordians and Canadians:
  • Invest in education;
  • Improve access to decent, affordable housing;
  • Improve access to nutritious, affordable food;
  • Give people more control over their jobs and improve wages;
  • Reduce the gap between rich and poor.

You do this through your vote, and by writing to your local MP.

• Locally, talk to your union or student organizations and encourage them to get involved in these issues that impact the health of their members.
• Get involved in one or two issues that resonate with you. Offer support to local community and advocacy groups that are acting on the issues: write an encouraging email, sign a petition, make a donation or join up! One useful tool is the Public Health Agency of Canada's Primer to Action. This document introduces different determinants and provides links and examples. The section titled "What Actions Can you Take?" lists practical strategies you can use in your community.