abstract: 'This paper uses a comparative case study of Canada and the USA to argue

  that, in order to fully understand the associations between population

  health and the socioeconomic environment we must begin to place

  importance on the dynamic aspect of these factors-examining them as they

  evolve over time. In particular, for institutional and policy shifts

  that often unfold over decades, population health must attend to these

  big, slow moving processes by adopting a historical perspective to the

  knowledge base. We compare Canada and the USA on basic health outcomes

  and a range of determinants of health for which routine data have been

  collected for all or most of the period between 1950 and the present.

  During the analysis that follows, we are able to establish that, at the

  level of society (i) greater economic well being and spending on health

  care does not yield better health outcomes, that (ii) public provision

  and income redistribution trump economic success where population health

  is concerned, and (iii) that the gradual development of public provision

  represents the buildup of social infrastructure that has long-lasting

  effects on health status. Our case study shows what can be gleaned from

  a comparative perspective and a long-term view. The long view allows us

  to detect the gradual divergence in health status between these two

  societies and to trace potential institutional causes that would

  otherwise go unnoticed. The perspective introduced here, and in

  particular the comparison of Canada and the USA, provides strong support

  for the use of cross-national comparative work, and a historical

  perspective on the investigation of societies that successfully support

  population health. (c) 2006 Elsevier Ltd. All rights reserved.'
affiliation: 'Siddiqi, A (Corresponding Author), Univ Tennessee, Knoxville, TN 37996
  USA.

  Univ Tennessee, Knoxville, TN 37996 USA.'
author: Siddiqi, Arjumand and Hertzman, Clyde
author-email: 'asiddiqi@utk.edu

  hertzman@interchange.ubc.ca'
author_list:
- family: Siddiqi
  given: Arjumand
- family: Hertzman
  given: Clyde
da: '2023-09-28'
doi: 10.1016/j.socscimed.2006.09.034
files: []
issn: 0277-9536
journal: SOCIAL SCIENCE \& MEDICINE
keywords: 'income inequality; Canada; USA; social epidemiology; historical

  analysis; structural determinants; institutional determinants'
keywords-plus: 'CROSS-SECTIONAL ANALYSIS; INCOME INEQUALITY; SOCIOECONOMIC-STATUS;

  INDIVIDUAL INCOME; LIFE EXPECTANCY; MORTALITY; ADULTS'
language: English
month: FEB
number: '3'
number-of-cited-references: '44'
pages: 589-603
papis_id: 5099e281faa04297b30dec23f7545d0c
ref: Siddiqi2007epidemiologicalunder
times-cited: '51'
title: 'Towards an epidemiological understanding of the effects of long-term institutional
  changes on population health: A case study of Canada versus the USA'
type: article
unique-id: WOS:000244260900008
usage-count-last-180-days: '0'
usage-count-since-2013: '12'
volume: '64'
web-of-science-categories: 'Public, Environmental \& Occupational Health; Social Sciences,

  Biomedical'
year: '2007'