CSDH report
The Commission on Social Determinants of Health is a global coalition of policymakers, researchers, and civil society that was established to marshal the evidence on what can be done to promote health equity and inspire a global movement to achieve it. The focus is on countries of all income levels and stages of development. In 2008, the Commission released its final report. The important results and recommendations are summarized in this document; the full list can be found in the final report.1,2
Sources:
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- CSDH 2008. Closing the gap in a generation: health equity through action on the social determinants of health. Final Report of the Commission on Social Determinants of Health. Geneva, World Health Organization. Available from https://www.who.int/publications/i/item/9789241563703
- CSDH 2005. Action on the social determinants of health: Learning from previous experiences. A background paper prepared for the Commission on Social Determinants of Health. Available from https://www.who.int/social_determinants/resources/action_sd.pdf
Action on SDHs in tackling noncommunicable diseases
A strategy that focuses primarily on treatment or tries to replicate recent HIV and tuberculosis programs overlooks key lessons and risks failing to combat noncommunicable diseases. Treatment advancements for HIV and tuberculosis must be balanced against slow progress in reducing incidence and the need for a renewed focus on prevention.
The well-known example of combining community engagement and collaboration with industry to reduce salt and fat intake and reorient agriculture in North Karelia, Finland, demonstrates how well-coordinated policies addressing social determinants can help to reduce noncommunicable diseases. Despite this, far too little has been done globally to investigate how food production and distribution policies may be better coordinated to support health and development objectives.
Source: Rasanathan, K.& Krech, R. 2011. Action on social determinants of health is essential to tackle noncommunicable diseases. Bulletin of the World Health Organization, 89 (10), 775 – 776. World Health Organization. Available from http://dx.doi.org/10.2471/BLT.11.094243
Critical SDH analysis
According to Lundberg (2020) there is a need for a new way of framing and explaining what the SDH approach is all about. Essentially, it’s a request for a more straightforward and pedagogical manner of describing what we mean and refer to when we discuss socioeconomic determinants of health. The demand for a fresh narrative stems from difficulties in communicating and collaborating with other sectors.
A new narrative, on the other hand, cannot just be about renaming or rebranding the SDH strategy. Rather, it is crucial to examine why it may be difficult to communicate and understand this perspective, when in fact this perspective should resonate well with most people’s professional knowledge and everyday experiences.
The elements of the new narrative need to consider following dimensions: The understanding of how poor health is caused, avoiding determinism, understanding structural versus individual level drivers, and handling the abundance of factors and groups.
Source:
Lundberg, O. 2020. Next steps in the development of the social determinants of health approach: the need for a new narrative. Scandinavian Journal of Public Health, 48(5), 473–479. https://doi.org/10.1177/1403494819894789
More:
Eckersley, R. 2015. Beyond inequality: Acknowledging the complexity of social determinants of health. Social Science & Medicine 147: 121–125. https://doi.org/10.1016/j.socscimed.2015.10.052