Africanizing the Social Determinants of Health: Embedded Structural Inequalities and Current Health Outcomes in Sub-Saharan Africa

Abstract

There is a growing interest in health policy in the social determinants of health. This has increased the demand for a paradigm shift within the discipline of health economics from health care economics to health economics. While the former involves what is essentially a medical model that emphasizes the maximization of individual health outcomes and considers the social organization of the health system as merely instrumental, the latter emphasizes that health and its distribution result from political, social, economic, and cultural structures. The discipline of health economics needs to refocus its energy on the social determinants of health but, in doing so, must dig deeper into the reasons for structurally embedded inequalities that give rise to inequalities in health outcomes. Especially is this the case in Africa and other low- and middle-income regions. This article seeks to provide empirical evidence from sub-Saharan Africa, including Ghana and Nigeria, on why such inequalities exist, arguing that these are in large part a product of hangovers from historically entrenched institutions. It argues that there is a need for research in health economics to embrace the social determinants of health, especially inequality, and to move away from its current mono-cultural focus.

COVID-19 Pandemic, a War to be Won: Understanding its Economic Implications for Africa

“…From studies on socioeconomic inequalities in health, we know that poor and vulnerable populations may bear a greater burden of COVID-19 in the long term [26,27]. However, the full economic impact of COVID-19 on the economies of countries in Africa cannot be ascertained at the moment as the situation unfolds.…”

Social determinants of health: the role of effective communication in the COVID-19 pandemic in developing countries

“…Addressing the SDH is essential for reducing health inequalities [7,[21][22][23][24][25][26], especially in developing countries with weak health systems. Thus, we argue that the COVID-19 outbreak that is compounding morbidity and mortality has put a spotlight on the SDH as central for improving population health in developing countries.…”

Sociodemographic Characteristics and Health Profile of the Elderly Seeking Health Care in Kampala, Uganda

“…Longitudinal studies from developed countries have found a causal relationship between socioeconomic position and ADL [ 66 ]. However, measures of socioeconomic status may not necessarily be interpreted the same way in the African context [ 67 ]. Therefore, longitudinal studies set in sub-Saharan Africa are needed to elucidate the association between financial dependency and functional status among the elderly.…”