From barriers to breakthroughs: social determinants of health
Pharmacists across Canada are uniquely positioned to move beyond prescriptions and address the real-life factors shaping patients’ health—from housing and food stability to transportation and social connection. That was the central message of a recent Canadian Foundation for Pharmacy (CFP) webinar, Mission Possible: How pharmacists can take action on social determinants of health. The webinar featured four speakers who shared practical strategies, research and frontline experiences that are already making a difference.
Moderated by Angeline Ng, Vice-President of Professional Affairs at the Ontario Pharmacists Association, the session highlighted how pharmacists can identify barriers, connect patients to supports and ultimately improve health equity.
The need for social prescribing
Tarek Hussein, owner of Weller Pharmacy in Kingston, Ontario, and Chief Development Officer of the International Social Prescribing Pharmacy Association, emphasized that health outcomes are largely shaped outside the healthcare system. “When we talk about what makes people healthy…healthcare is only a portion of the picture,” he said, noting that up to 90% of health is influenced by social and environmental factors.
Hussein described social prescribing as a structured way to identify non-medical needs and connect patients to community supports. In practice, that can mean addressing issues like housing or loneliness instead of adding another medication. In fact, his work focuses on embedding screening and social prescribing directly into routine patient care—turning what are often informal observations into structured, actionable interventions.
At his pharmacy, that means training teams to look beyond the prescription and identify early warning signs—missed refills, cost-related non-adherence or sudden disengagement. These “friction points,” as Hussein described them, often signal underlying social barriers that need to be addressed before any treatment plan can succeed.
A simple example from his own experience underscores the impact: repeated respiratory illness in a family was ultimately traced to mold in their housing. “If we don’t do a referral to housing…this outcome will never be favourable,” he said.
Read more here about how pharmacies can incorporate social prescribing.
Screening for what really matters
Dr. Tiffany Lee, pharmacist and Assistant Professor, School of Pharmacy, Memorial University of Newfoundland, is leading research on the SPARK screening tool, designed to help pharmacists systematically identify social needs.
“Patients are willing to talk to their pharmacist about their social needs,” she said, noting a high uptake rate in the study.
Pharmacists involved in the pilot are incorporating screening into routine care—from medication reviews to immunizations—then working with patients to connect them with local supports. The process takes an average of about 16 minutes, demonstrating that meaningful intervention can be integrated into everyday practice.
Lee added that patients often feel more supported when asked about their broader circumstances. “It puts the care back in health care,” she said.
Turning barriers into care plans
For Solmaz Nafez, manager of Shawano Pharmacy in Winnipeg, Manitoba, addressing social determinants is part of her daily practice serving predominantly Indigenous communities, many in remote locations. “Behind a missed dose, there is usually a barrier, not non-compliance,” she said.
Her team proactively plans around those barriers, whether that means coordinating medication deliveries around unreliable transportation, arranging safe storage for medications or navigating complex coverage systems.
In one case, an infant in a remote community urgently needed specialized formula. With no local pharmacy access, Nafez coordinated emergency delivery and worked with providers to prevent future gaps.
Her approach is simple but powerful: “If we don’t identify the barrier, the plan is not real.”
Meeting patients where they are
In Regina, Saskatchewan, pharmacist Sarah Kozusko has taken an even broader approach—transforming her Queen City Wellness Pharmacy into a hub for care, connection and support for underserved populations.
“The majority of my day is…at the intersection of healthcare and survival,” she said.
Her pharmacy now offers food programs, clothing, harm reduction services and on-site access to social workers and healthcare providers. These initiatives grew from recognizing that unmet basic needs—like food or housing—make traditional care plans unrealistic.
“You can’t counsel somebody on their medication adherence when they haven’t eaten,” Kozusko said.
A call to action
Across all four presentations, a common message emerged: addressing social determinants of health is not about adding more work—it’s about rethinking pharmacy practice.
Pharmacists are often the most accessible healthcare providers, making them ideally positioned to identify unmet needs and connect patients to meaningful support.
As Ng concluded, the opportunity lies in seeing pharmacy practice differently and using every patient interaction as a chance to improve lives. Read more on pharmacists taking action on social determinants of health in CFP’s 2025 Changing Face of Pharmacy report.
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