About

Through the work of researchers such as Sir Michael Marmot, we now understand that good health does not lie solely with medical interventions but also with living conditions and personal choices (4, 5). Determinants of health are lifestyle-based properties affected by broader social, economic, and political forces that influence quality of personal health. These attributes include but are not limited to education level, employment, income level and distribution, housing, childhood development, food security and nutrition, race, gender, and stress. Such factors have been shown to have marked associations with risks for different illnesses, life expectancy, and life-time morbidity. In recent decades, increasing health disparities in developed countries and between developing and developed countries have been associated with these social factors. While public health workers and policymakers seek to reduce this divide, they face challenges in designing and implementing programs that are comprehensive enough to address issues that have complex, long-term, causal relationships with specific disease pathways. However, both the motivation and action to develop effective research and intervention methods continue to grow in this field of public health (1).

News/Events

• World Conference on Social Determinants of Health (Agenda). Oct 19-21, 2011 
• From Disparities Research to Disparities Interventions: Lessons Learned and Opportunities for the Future of Behavioral Health Services conference. Apr 5-8, 2011 
• Doctors urged to be patient with patients (a short dialogue between Sir Michael Marmot and David Mark). Australian Broadcasting Corporation Apr 5, 2011
• It's time for a new development model. The Guardian Apr 5, 2011 
• Promoting Health Equity: Action on the Social Determinants of Health conference. Feb 11-12, 2011 
• 60% of poorest children fail to reach good level of behaviour, says study. Feb 11, 2011   

Documents and publications

• Commission on Social Determinants of Health, WHO. Closing the gap in a generation: Health equity through action on the social determinants of health.  
• Link HG & Phelan, J. Social Conditions as Fundamental Causes of Disease. 
• Marmot M. Social determinants of health inequalities. 
• Marmot Review Commission. Fair society, healthy lives: The Marmot review.  
• Mikkonen J & Raphael D. Social Determinants of Health: The Canadian facts.
• Solar O & Irwin A. A conceptual framework for action on the social determinants of health.
• Irwin A & Scali E. Action on the social determinants of health: Learning from previous experiences.
• Pega F, Valentine N, & Matheson D. Monitoring social well-being to support policies on the social determinants of health: The case of New Zealand's "social reports/ te pūrongo oranga tangata."
• WHO. Monitoring equity in access to AIDS treatment programmes: A review of concepts, models, methods and indicators. 

Methodologies

• Oakes J, Kaufman J. Methods in social epidemiology  
• Epstein D, Jiménez-Rubio D, Smith PC, Suhrcke M. An economic framework for analysing the social determinants of health and health inequalities 
• WHO/Europe. Concepts and principles for tackling social inequities in health: Levelling up Part I 
• Shavers, V. Measurement of socioeconomic status in health disparities research 
• WHO. Urban Health Equity Assessment and Response Tool (Urban HEART)

Tools

• PAHO/WHO Global Learning Device on Social Determinants of Health and Public Policy Formation (English/Spanish/Portuguese) 

Related links

• Social Determinants of Health – World Health Organization
• Social Determinants of Health – Centers for Disease Control and Prevention 
• Determinantes Sociales – Ministerio de Salud de Chile 
• Strong Medicine for a Healthier America – Robert Wood Johnson Foundation 
• MacArthur Research Network on Socioeconomic Status and Health 
• Center for Social Epidemiology and Population Health 
• Hopkins Center for Health Disparities Research 
• Fair Society, Healthy Lives – Marmot Review 
• Let’s Move! Campaign 
• Healthy People 2020 
• Health Disparities Community Solutions Database (for related programs and campaigns) 

Areas of Work

• Utilizing health promotion and health education approaches to promote informed, comprehensive, upstream participatory decision-making and action
• Determining associations between social factors and health status  
• Creating scientific methodologies for examining social factors in health
• Reducing health disparities and promoting equal access to health care
• Applying social theory to health and illness
• Measuring and monitoring social factors
• Human Security
• Violence
• Urban Health and Healthy Settings
• Worker's Health 

Figures

The below figures demonstrate that improved social conditions and better health status often have a positive, step-wise, incremental gradient association (2). Click on the figure to enlarge:

Citations

1. Braveman PA, Cubbin C, Egerter S, Williams DR. 2011. The social determinants of health: coming of age. Annu. Rev. Public Health 32:3.1-3.18
2. Braveman PA, Cubbin C, Egerter S, Williams DR, Pamuk E. 2010. Socioeconomic disparities in health in the United States: what the patterns tell us. Am. J. Public Health 14:20–35
3. Dahlgren G, Whitehead M. 1991. Policies and strategies to promote social equity in health: background document to WHO – strategy paper for Europe. Institute for Future Studies: Stockholm
4. Marmot M. 2005. Social determinants of health inequalities. Lancet 365: 1099-1104
5. Marmot MG, Davey Smith G, Stansfeld S, Patel C, North F, et al. 1991. Health inequalities among British civil servants: the Whitehall II study. Lancet 337:1387–93