Social determinants of health

From Wikipedia, the free encyclopedia

Social determinants of health are the economic and social conditions under which people live which determine their health; illnesses that are generally related to social, economic, political, and environmental circumstances. Social determinants of health have been recognized by several health organizations such as the Public Health Agency of Canada and the World Health Organization to greatly influence collective and personal well-being. A list of determinants of health -- only some of which are social determinants -- compiled by the Public Health Agency of Canada is below:

Income and social status
Social support networks
Education and literacy, e.g. health literacy
Employment/Working conditions
Social environments
Physical environments
Personal health practices and coping skills
Healthy child development
Biology and genetic endowment
Health services
Gender
Culture

The term social determinants of health grew out of the search by researchers to identify the specific exposures by which members of different socio-economic groups come to experience varying degrees of health and illness. While it was well documented that individuals in various socio-economic groups experienced differing health outcomes, the specific factors and means by which these factors led to illness remained to be identified Overviews of the concept, recent findings, and an analysis of emerging issues are available. All these formulation share a concern with factors beyond those of biomedical and behavioural risk.

The SDOH National Conference list (see Raphael, below) is unique in that it specifically focuses on the public policy environment (e.g., income and its distribution) rather than characteristics associated with individuals (e.g. income and social status). These 11 social determinants of health are:

Aboriginal status
early life
education
employment and working conditions
food security
health care services
housing
income and its distribution
social safety net
social exclusion
unemployment and employment security.

World Health Organization. (1986). Ottawa charter for health promotion. World Health Organization European Office. Available: http://www.who.int/hpr/NPH/docs/ottawa_charter_hp.pdf
Health Canada. (1998). Taking action on population health: A position paper for health promotion and programs branch staff. Ottawa: Health Canada. Available: http://www.phac-aspc.gc.ca/ph-sp/phdd/pdf/tad_e.pdf
Wilkinson, R., & Marmot, M. (2003). Social determinants of health: The solid facts. World Health Organization, European Office. Available: http://www.euro.who.int/document/e81384.pdf
Raphael, D. (Ed.). (2004). Social determinants of health: Canadian perspectives. Toronto: Canadian Scholars’ Press: http://www.cspi.org/books/s/socialdeter.htm
Raphael, D., Bryant, T., and Rioux, M. (Eds. (2006). Staying alive: Critical perspectives on health, illness, and health care. Toronto: Canadian Scholars’ Press:

http://www.cspi.org/books/s/staying.htm

Zarcadoolas, C., Pleasant, A., & Greer, D. (2006) Advancing health literacy: A framework for understanding and action. Jossey-Bass:San Francisco, CA. Available at http://www.amazon.com/gp/product/0787984337/sr=8-1/qid=1154045130/ref=pd_bbs_1/102-7022731-3268930?ie=UTF8