The Last Straw! A Board Game on the Social Determinants of Health©
Developed by Kate Rossiter and Kate Reeve

** Recently ranked 12th among top 25
resources on social determinants of health by Health Nexus!
For information in English

Pour de l'information en français

** New book chapter!
For information

* Ya están a la venta las copias en español/inglés!
Más información

The Last Straw! is a fun and exciting teaching tool on the social determinants of health. The game has three objectives:
  • to promote discussion about the social determinants of health;
  • to help players build empathy with marginalized people and gain an awareness of players' own social location;
  • to encourage learning in a fun and supportive environment.

In keeping with current research on the social determinants of health, socioeconomic status is a primary determinant of health in this game, as are race, gender, sexual orientation and other factors.

Feedback consistently demonstrates that players gain a better understanding of the social determinants of health and the interplay between forces at individual and community levels.  Both players and facilitators
("Game Masters") report having a great time playing the game.

We have also developed a training manual and video to help Game Masters get the most out of the game.


How to Play
The Last Straw! can be played with almost any number of players, from a small group of 4 or 5 to a larger group of 25.  We've even adapted it to a lecture theatre! The ideal number is about a dozen.

The Last Straw! takes players through the life cycle where they will encounter "macro" issues such as political climate, economic structure and environmental change, as well as "micro" issues, such as individual finances, education, and family dynamics.
Each player develops a character profile that includes gender, socio-economic status and race.  The player then receives Vitality Chips based on this profile. 

Each character moves through various life stages from Childhood, to Adolescence, to Adulthood and finally to Old Age, updating the profile as the character passes from one life stage to the next. 

On the board, a character encounters two kinds of squares: individual scenarios, which the Game Master reads out loud out from the Game Guide, and Community Cards, which affect all the characters on the board and are read aloud by the players themselves. 

A character then gains or loses Vitality Chips based on these scenarios and community events.

The character who has the most Vitality Chips at the end of the game wins!
The Last Straw! is participatory education at its most innovative and entertaining!



(c) 2007 Kate Reeve and Kate Rossiter