Family as a social determinant of health: implications for governments and institutions to promote the health and well-being of families.

A growing appreciation of the powerful impact of the social determinants of health, particularly the toxic effect of poverty on health, is driving the need for a re-evaluation of the role of governments and institutions such as hospitals in the lives of children and families. The well-being of families is the cornerstone on which society rests; yet evidence is growing that families are facing significant challenges beyond their control that adversely impact their ability to perform their essential role. With evidence of a growing divide in society--an expanding gap between the rich and the poor (Novak 2007)--contributing to a polarization of health and social outcomes along this continuum, there is an urgent need for revisioning priorities for health and social policies. Bold new ideas and leadership are needed to plan a future that encompasses social justice as a key value and operating assumption.