Background: In high-income countries, such as Canada, 50% of health outcomes are attributable to social determinants. Occupational opportunities are also structurally determined, yet these inequities are obscured by the White, Western assumptions and ableist neoliberal ideology in which the profession is deeply rooted. Purpose. To highlight the impact of structural injustices and other social determinants of health and occupation; explore the occupational therapy profession's structural competence; and build on existing knowledge to advance an agenda for action on injustice and inequity for the occupational therapy profession. Key issues. Occupational therapy's failure to prioritize education, research and action on systemic injustices and other social determinants of health and occupation reflects a lack of commitment to achieving the World Federation of Occupational Therapists' Minimal Standards. Implications. If occupational therapy is to advance knowledge and practices that address inequities in the social and structural determinants of health and occupation, we must strive towards structural competence.

背景：在加拿大等高收入国家，50% 的健康结果可归因于社会决定因素。职业机会也是结构性决定的，但这些不平等被白人、西方假设和职业根深蒂固的新自由主义意识形态所掩盖。目的。强调结构性不公正和健康和职业的其他社会决定因素的影响；探索职业治疗专业的结构能力；并在现有知识的基础上推进一项针对职业治疗行业不公正和不平等的行动议程。关键问题。职业治疗未能优先考虑关于系统性不公正和其他健康和职业的社会决定因素的教育、研究和行动，这反映了对实现世界职业治疗师最低标准的承诺。影响。如果休闲治疗要推进知识和实践，以解决健康和休闲的社会和结构决定因素中的不平等问题，我们必须努力实现结构能力。