Toronto charter outlines future health policy directions for Canada and elsewhere.

conference of more than 400 Canadian social and health policy experts, community representatives and health researchers met at York University in Toronto, Canada, to consider the state of 10 key social or societal determinants of health across Canada, to explore the implications of these conditions for the health of Canadians and to outline policy directions to improve the health of Canadians by influencing the quality of these determinants of health. The conference took place at a time when Canadian social and health policies were undergoing profound changes related to shifting political, economic and social conditions (Bryant, 2002). The conference was funded by the Policy Research Program of Health Canada, with support from the Canadian Institutes for Health Research, in the tradition of Canadian government action on the determinants of health. It brought together representatives from a wide range of sectors: labour, childcare, food security, social development , anti-poverty, housing, education, and many others. Ten social determinants of health—early life, education, employment and working conditions , food security, health services, housing, income and income distribution, social exclusion, the social safety net, and unemployment and job insecurity— were examined. These were chosen on the basis of their prominence in Health Canada and World Health Organization (WHO) policy statements, and because social and economic restructuring has profoundly affected the quality of these determinants of health in Canada (Raphael, 2003). The conference was also a response to accumulating evidence that growing social and economic inequalities among Canadians are contributing to higher health care costs and other social burdens. Indeed, the recent Canadian Senate Report on the Federal Role in Health Care points out that 75% of Canadians' health is determined by physical, social and economic environments (Kirby, 2002). Evidence was also accumulating that a high level of poverty—an outcome of the growing gap between rich and poor—has profound societal effects as poor children are at higher risk for health and learning problems in childhood, adolescence and later life, and are less likely to achieve their full potential as contributors to Canadian society (Raphael, 2003). As a result of the conference, the Toronto Charter on the Social Determinants of Health was developed. It drew upon initial feedback by conference participants and was then ratified by conference participants. The Peterborough and Toronto Boards of Health and Ottawa Toronto City Council have since endorsed the Charter and it is going before additional municipal councils across Canada for …