Paul Kershaw

Associate Professor

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Graduate Student Supervision

Master's Student Supervision (2010 - 2018)
Measuring the social determinants of health for young British Columbian adults, 1976-2016 (2018)

BACKGROUND: Out of a concern that social determinants of health (SDOH) for young British Columbian adults are in decline, this project aims to explore any intergenerational inequities in SDOH for young adults that may or may not have arisen between 1976 (when the “baby boom” cohort came of age as young adults) and 2016.METHOD: This work is done by visualizing and discussing temporal trends in population-level observational data that describe the SDOH for young British Columbian adults aged 25-44, between the years of 1976 and 2016. Age-adjusted aggregate and per capita revenue and expenditure at the federal and provincial levels are explored, as is public and environmental debt.RESULTS: More recent younger generations in BC face worse social and economic conditions compared to a generation ago, and have made notable individual-level adaptations to cope. Public policy has been slower to adapt for younger generations, with provincial and federal governments prioritizing spending on an older demographic. Public and environmental debts have increased and grown less sustainable over the past 40 years. DISCUSSION: The majority of new public investment has gone to those over age 65, even though that group enjoys greater ability to pay than age cohorts immediately before and after it. My findings propose two key policy options: first, the conditions younger adults in BC face are largely modifiable through a concerted public policy response that shifts revenue generation and/or social spending in ways that reallocate from older to younger; second, a health in all policies analysis invites us to reconsider the continued growth in health care spending, instead allocating new revenue towards social spending such as child care and public transportation.

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