Government policies from 2010 have increased the slope rather than levelled up. It is time to reverse course, writes Michael Marmot

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This chapter applies the conceptual framework of the social determinants of health to discuss determinants of mental health across the life course. The health and well-being of individuals is strongly influenced by social determinants. Social determinants of health (SDH) encompass wider social, economic, environmental, cultural, and political factors that shape health-related behaviours and physical and mental health outcomes. SDH can be summarized as the conditions in which people are born, grow, live, work, and age. Systematic inequalities within societies create differential experiences of social determinants across the life course, and an accumulation of positive and negative effects of social determinants shape inequalities in health. The conceptual framework describes structural factors, political, and economic factors across the lifespan. The schooling, work environment, and natural and built environment, including housing, are important factors in good health. The impact of social factors on health, including mental health, is well recognized. The relationship between physical health and mental health is bidirectional. Psychosocial factors such as work stress affect mental health. Having control over aspects of life underpins how individuals cope with stressors and is key to mental health and well-being.

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