Social Determinants of Health: Present Status, Unanswered Questions, and Future Directions

Abstract

This article reviews the current status of theory and research concerning the social determinants of health. It provides an overview of current conceptualizations and evidence on the impact of various social determinants of health. The contributions of different disciplines--epidemiology, sociology, political economy, and the human rights perspective--to the field are acknowledged, but profound gaps persist in our understanding of the forces that drive the quality of various social determinants of health and why research is too infrequently translated into action. Many of these gaps in knowledge concern the political, economic, and social forces that make implementation of public policy agendas focused on strengthening the social determinants of health problematic. The author identifies the areas of inquiry needed to help translate knowledge into action.

Soziale Ungleichheit und Gesundheit

“…Wie Menschen leben und arbeiten, wie das Einkommen in der Gesellschaft verteilt und wie das Gesundheitssystem organisiert ist: All diese Faktoren entstehen nicht in einem Vakuum [104][105][106]. Die Commission on Social Determinants of Health hat in ihrem Bericht für die WHO deutlich unterstrichen, dass die Qualität der sozialen Determinanten der Gesundheit durch politische, öko-nomische und soziale Kräfte geformt wird, die sich je nach Land und Region unterscheiden können [9].…”

Social Sustainability and Its Indicators through a Disability Studies and an Ability Studies Lens

“…The Hans Böckler Foundation has initiated and funded a project to analyze the interlinkages of social sustainability with special emphasis on labor and health with economic and environmental sustainability [61]. The environment in which an individual lives is seen as having a major impact on shaping the individuals quality of life and as such their health and well-being [22,64]. This, we posit, suggests that the existing discourse of SDH [7,62,63], which are indicators of health, could and should be linked to the social sustainability discourse.…”

“…SDH's 1-10 could be seen as basic needs (a focus of the development sustainability concept) although not all basic needs (for example water, sanitation, energy) are covered by the SDH list; however, we posit that these are useful indicators to be added as targets for social sustainability indicators. Addressing these determinants might lessen the large gap between the quality of life of different groups of individuals [64]. Four sets of marginalized groups (Aboriginal status, disability, gender and race) are in actuality SDH, suggesting that these groups are disadvantages simply by being themselves (interestingly disabled people are also invisible in SDH discourses [59]).…”

The Impact of Education Across Sectors and the Millennium Development Goals

“…Level of education has been found to be a powerful predictor of mortality and overall morbidity across the lifespan (Lleras-Muney, 2005), with people who have not completed high school at risk of a shorter life compared with those who do complete (Muller, 2002;Sundquist & Johansson, 1997). As well as being associated with a substantial reduction in educational outcomes, low socioeconomic status and poverty during childhood and adolescence are independent predictors of a number of illnesses including heart disease, cancer and diabetes (Albano et al, 2007;Kinsey, Jemal, Liff, Ward & Thun, 2008;Raphael, 2006). Children from such backgrounds are more likely to miss school due to illness, have poorer school performance and overall lower expectations about their educational achievements (Jackson, 2009).…”