Small scale conflict with large-scale violence threatens health security and may experience increased incidence and prevalence in fragile and failed states. Preventative policy to resuscitate fragile and failed states and prevent further external and internal shocks may support health and promote a positive feedback loop of further state stability and increased health security. Public health policy shift to mitigate state failure and public health crisis in war and conflict through the basis of primary prevention may provide best practices and maximize health security for at risk populations.

COVID-19 pandemic is a stark example of health security politics, despite the pandemic not being currently labeled as a health security concern in political discourse. With high levels of morbidity and mortality globally and a highly contagious pathogen this pandemic is a prime and unprecedented example of a global health security threat. Analyses of the politics and practicalities of confronting health-related threats, of policy options and institutional approaches, however, hinge on the way these challenges are constructed and on the way the dimensions of the concept of health security are charted. In 2015 Horton and Das noted that there was no simple definition of health security. [5] Indeed, there has been little consensus among analysts over the meaning and parameters of health security. [16-19] These disagreements, Aldis argues, have effects beyond analytical debates, as they hinder communications and collaboration on global health initiatives, creating confusion and mistrust among stakeholders. [18] They also inhibit comparative evaluation, critique of existing analysis, or the possibility of consistent policy recommendations. Conceptual analyses of the two constitutive parts of health security illustrate the difficulties of coming up with a simple definition and the inherent tensions and contestations in such debates. Given these difficulties, it is argued here that a framework for conceptual analysis of "health security," instead of a fixed definition, would provide valuable space to evaluate the key features of existing analysis, the explicit and implicit assumptions about the nature and parameters of health security politics underpinning current policy responses, as well as possible alternative conceptualizations and ways of thinking about health security. Health security politics is a burgeoning and contested field of analysis and practice with the potential to affect security thinking beyond its own parameters. This article aims to contribute to debates both about the scope and meaning of health security and about the scope and meaning of security more broadly. To achieve this, it first presents a brief review of the scope and focus of contemporary conceptual debates of health security; second, it applies Baldwin's [20] framework for the concept of security to demonstrate how conservative the current definition of health security is; and thirdly, it proposes an alternative framing with a view to demonstrate the benefits of thinking about health security in broader more inclusive ways, which has the potential to improve global responses to current and future health-related challenges. Discussions of the politics and practicalities of confronting health security challenges-from infectious disease outbreaks to antimicrobial resistance and the silent epidemic of noncommunicable diseases-hinge on the conceptualization of health security. There is no consensus among analysts about the specific parameters of health security. This inhibits comparative evaluation and critique, and affects the consistency of a...

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The inclusion of social determinants of health offers a more comprehensive lens to fully appreciate and effectively address health. However, decision-makers across sectors still struggle to appropriately recognise and act upon these determinants, as illustrated by the ongoing COVID-19 pandemic. Consequently, improving the health of populations remains challenging. This paper seeks to draw insights from the literature to better understand decision-making processes affecting health and the potential to integrate data on social determinants. We summarised commonly cited conceptual approaches across all stages of the policy process, from agenda-setting to evaluation. Nine conceptual approaches were identified, including two frameworks, two models and five theories. From across the selected literature, it became clear that the context, the actors and the type of the health issue are critical variables in decision-making for health, a process that by nature is a dynamic and adaptable one. The majority of these conceptual approaches implicitly suggest a possible role for data on social determinants of health in decision-making. We suggest two main avenues to make the link more explicit: the use of data in giving health problems the appropriate visibility and credibility they require and the use of social determinants of health as a broader framing to more effectively attract the attention of a diverse group of decision-makers with the power to allocate resources. Social determinants of health present opportunities for decision-making, which can target modifiable factors influencing health—i.e. interventions to improve or reduce risks to population health. Future work is needed to build on this review and propose an improved, people-centred and evidence-informed decision-making tool that strongly and explicitly integrates data on social determinants of health. Supplementary Information The online version contains supplementary material available at 10.1007/s11524-021-00560-z.

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