Root Out, Reach Out!                                  Young People in                                  Addressing the     ...
Outline• Social Determinants of Health and  Health Equity• The World Conference in Rio• The Role of IFMSA, Medical  Studen...
Social Production of Disease             Do we not always           find the diseases of               the populace       ...
Source: Ravi Narayan, SOCHARA, India
Social Determinants of Health• Conditions in the social, physical, and  economic environment in which people  are born, gr...
SDH – Roots of Health Inequities• Inequalities in health – ‘differences’ in health across  individuals / population groups...
Global InequitiesLife Expectancy at Birth (Men)                         Marmot, 2007
Mortality over 25 years according to level in the                occupational hierarchy: Whitehall(Marmot & Shipley, BMJ, ...
Life expectancy and disability-free life expectancy at birth by neighbourhood income deprivation, 1999-2003
The Jubilee Line of Health InequalityTravelling east from Westminster, each tube stop representsup to one year of male lif...
LEB under 60 years                                         IMR over 90                                         MM over 150...
Commissioners• Sir Michael Marmot (Chair)• 18 others representing academics, politicians,  civil society, senior public he...
“Unequal distribution of health-  damaging experiences is not in any  sense a ‘natural phenomenon, but is  a result of the...
CSDH Report: Action Areas                              •   Equity from the startDaily Living Conditions                   ...
Basic question: What good does it do to          treat people’s Illnesses …only to send them back to the conditions       ...
The Rio World Conference“To engage high level political support to  make progress on national policies to  address social ...
Five Thematic Areas•   Adopt better governance•   Promote participation•   Reorient the health sector•   Strengthen global...
Major Achievements• Revival of the Alma Ata spirit• Governments start speaking the  SDH language• WHO engagement with civi...
Alma Ata, 1978The International Conference on PrimaryHealth Care calls for urgent action by allgovernments, all health and...
The New “Alma Ata”?• It needed to be said again.• We know a great deal more than  we did.• The CSDH gave practical  direct...
Major Criticisms• Avoided the crucial questions –  structural determinants of health• Lack of coherence with other  pressi...
Picture of Presidents in   Jakarta MM2011
IFMSA Small Working Group onHealth Inequities
Next Steps• General Assembly in Ghana on “Youth  and Social Determinants of Health”• IFMSA Global Health Equity Initiative...
POOR GLOBAL HEALTH      SICK WORLD       HEALTH INEQUITY    within and among nationsSOCIAL, POLITICAL, ECONOMIC,CULTURAL, ...
My Challenges• SDH to shape the post-MDG world              radicate      mprove maternal              extreme       healt...
My Challenges• Revitalize and enhance the SDH  movement in the Philippines
My Challenges• UP Manila and UP College of Medicine as  leaders in action on social determinants of  health
My Challenges• Transformative scale-up of medical  education – integrate SDH thinking
My Challenges• The new Filipino physician as champion of  social determinants approach to health
The Power of Medicine               "Medicine… has the             obligation to point out            problems and to atte...
The Power of Young People“The youth arethe hope of the Fatherland.”     Dr. Jose Rizal National Hero of the Philippines
Fathers of Social Medicine
Health for All!Alma Ata, USSR, 1978       Almaty, Kazakhstan, 2008        Thank You Very Much!
Young People and Social Determinants of Health
Young People and Social Determinants of Health
Young People and Social Determinants of Health
Young People and Social Determinants of Health
Young People and Social Determinants of Health
Young People and Social Determinants of Health
Young People and Social Determinants of Health
Young People and Social Determinants of Health
Young People and Social Determinants of Health
Young People and Social Determinants of Health
Young People and Social Determinants of Health
Young People and Social Determinants of Health
Young People and Social Determinants of Health
Young People and Social Determinants of Health
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  • Greet… Introduce oneself…
  • Frances Baum: Australia Professor of Public Health, Flinders University, Adelaide; Global Steering Committee, People's Health Movement Monique Bégin: Canada Professor Emeritus, Faculty of Health Sciences, University of Ottawa; former Canadian Minister of National Health and Welfare Giovanni Berlinguer: Italy Member of European Parliament; Professor of Hygiene, Occupational Health and of Bioethics (Emeritus), University "La Sapienza", Rome Mirai Chatterjee: India Coordinator of Social Security, Self-Employed Women's Association (SEWA) Manuel Dayrit: Philippines Secretary of Health, Philippines William Foege: USA Emeritus Presidential Distinguished Professor of International Health, Emory University, and Gates Fellow; former Director of the US Centers for Disease Control and Prevention Kiyoshi Kurokawa: Japan President of the Science Council of Japan Ricardo Lagos: Chile President of the Republic of Chile Stephen Lewis: Canada United Nations Special Envoy for HIV/AIDS in Africa Alireza Marandi: Iran Professor of Pediatrics at Shaheed Behesti University, Tehran; former Minister of Health and Medical Education, Islamic Republic of Iran Michael Marmot: UK Commission Chair and Director, International Centre for Health and Society, University College London Charity Ngilu: Kenya Minister of Health, Kenya Hoda Rashad: Egypt Research Professor and Director, Social Research Centre, American University of Cairo; Member of El Shoura Council of the Senate Amartya Sen: India 1998 Nobel laureate in economics; Lamont University Professor, Harvard University, Cambridge David Satcher: USA Interim President of the Morehouse School of Medicine, Atlanta, Georgia; former Surgeon General of the USA Anna Tibaijuka: Tanzania Executive-Director, UN-HABITAT Denny Vagero: Sweden Director of the Centre for Health Equity Studies (CHESS), Stockholm University/ Karolinska Institute
  • Young People and Social Determinants of Health

    1. 1. Root Out, Reach Out! Young People in Addressing the Social Determinants of Health Ramon Lorenzo Luis Rosa Guinto Regional Coordinator for the Asia-Pacific and Facilitator of the Small Working Groupon Health Inequities, International Federation of Medical Students’ Associations (IFMSA) Doctor of Medicine Class of 2012 University of the Philippines Manila
    2. 2. Outline• Social Determinants of Health and Health Equity• The World Conference in Rio• The Role of IFMSA, Medical Students, and Young People• My SDH Challenges
    3. 3. Social Production of Disease Do we not always find the diseases of the populace traceable to defects in society? Dr. Rudolf Virchow Father of Social Medicine
    4. 4. Source: Ravi Narayan, SOCHARA, India
    5. 5. Social Determinants of Health• Conditions in the social, physical, and economic environment in which people are born, grow, live, work, and age, including access to health care• Policies, programs, and institutions• Social structure, community factors
    6. 6. SDH – Roots of Health Inequities• Inequalities in health – ‘differences’ in health across individuals / population groups• Inequities in health – avoidable differences• ‘Where systematic differences in health are judged to be avoidable by reasonable action they are, quite simply, unfair. It is this that we label health inequity.’ WHO Commission on Social Determinants of Health (2008) From Mike Rowson, 2011
    7. 7. Global InequitiesLife Expectancy at Birth (Men) Marmot, 2007
    8. 8. Mortality over 25 years according to level in the occupational hierarchy: Whitehall(Marmot & Shipley, BMJ, 1996)
    9. 9. Life expectancy and disability-free life expectancy at birth by neighbourhood income deprivation, 1999-2003
    10. 10. The Jubilee Line of Health InequalityTravelling east from Westminster, each tube stop representsup to one year of male life expectancy lost at birth (2002-06)Male LifeExpectancy Male Life78.6 (CI 76.0-81.2) Expectancy Canning Town 72.8 (CI 71.1-74.6)Female Life Expectancy84.6 (CI 82.5-86.7) Female Life Expectancy 81.4 (CI 79.3-83.6) Westminster Canary London Bridge Wharf River Thames Canada North Bermondsey Water Greenwich Waterloo Southwark Electoral wards just a few miles apart geographically have life expectancy spans varying by years. For instance, there are eight stops between Westminster and Canning Town on the Jubilee Line – so as one travels east, each stop, onLondon Underground Jubilee Line average, marks up a year of shortened lifespan. 1 1 Source: Analysis by London Health Observatory using Office for National Statistics data revised for 2002-06. Diagram produced by Department of Health
    11. 11. LEB under 60 years IMR over 90 MM over 150LEB over 80 yearsIMR less than 10MM less than 15 Source: Dr. Ramon Paterno, University of the Philippines
    12. 12. Commissioners• Sir Michael Marmot (Chair)• 18 others representing academics, politicians, civil society, senior public health bureaucrats
    13. 13. “Unequal distribution of health- damaging experiences is not in any sense a ‘natural phenomenon, but is a result of the toxic combination of poor social policies and programs, unfair economic arrangements and bad politics.” WHO Commission on Social Determinants of Health, 2008
    14. 14. CSDH Report: Action Areas • Equity from the startDaily Living Conditions • Healthy places- healthy people • Fair employment –decent work • Social protection across the life course • Universal health care • Health Equity in All PoliciesPower, Money and • Fair financingResources • Market responsibility • Gender equity • Political empowerment – inclusion and voice • Good global governanceKnowledge, Monitoring • Monitoring, research, trainingand Skills • Building a global movement Full report downloadable at http://www.who.int/social_determinants/en/ Source: Fran Baum, Flinders University
    15. 15. Basic question: What good does it do to treat people’s Illnesses …only to send them back to the conditions that made them sick?
    16. 16. The Rio World Conference“To engage high level political support to make progress on national policies to address social determinants of health to reduce health inequities”
    17. 17. Five Thematic Areas• Adopt better governance• Promote participation• Reorient the health sector• Strengthen global cooperation• Monitor progress and increase accountability
    18. 18. Major Achievements• Revival of the Alma Ata spirit• Governments start speaking the SDH language• WHO engagement with civil society
    19. 19. Alma Ata, 1978The International Conference on PrimaryHealth Care calls for urgent action by allgovernments, all health and developmentworkers, and the world community to protectand promote the health of all the people ofthe world by the year 2000.
    20. 20. The New “Alma Ata”?• It needed to be said again.• We know a great deal more than we did.• The CSDH gave practical direction to realize Alma Ata.
    21. 21. Major Criticisms• Avoided the crucial questions – structural determinants of health• Lack of coherence with other pressing global issues• Rio Declaration drafted behind closed doors – lack of ambition
    22. 22. Picture of Presidents in Jakarta MM2011
    23. 23. IFMSA Small Working Group onHealth Inequities
    24. 24. Next Steps• General Assembly in Ghana on “Youth and Social Determinants of Health”• IFMSA Global Health Equity Initiative• Lancet - University of Oslo Commission on Global Governance for Health• Third People’s Health Assembly in Cape Town, July 6-11, 2012
    25. 25. POOR GLOBAL HEALTH SICK WORLD HEALTH INEQUITY within and among nationsSOCIAL, POLITICAL, ECONOMIC,CULTURAL, AND ENVIRONMENTAL Determinants of Health
    26. 26. My Challenges• SDH to shape the post-MDG world radicate mprove maternal extreme health poverty and hunger chieve ombat HIV/AIDS, malaria universal and other diseases primary educationromote gender equality nsure environmental and empower women sustainability educe child evelop a global mortality partnership for
    27. 27. My Challenges• Revitalize and enhance the SDH movement in the Philippines
    28. 28. My Challenges• UP Manila and UP College of Medicine as leaders in action on social determinants of health
    29. 29. My Challenges• Transformative scale-up of medical education – integrate SDH thinking
    30. 30. My Challenges• The new Filipino physician as champion of social determinants approach to health
    31. 31. The Power of Medicine "Medicine… has the obligation to point out problems and to attempt their theoretical solution…The physicians are the natural attorneys of the poor…” Dr. Rudolf Virchow Father of Social Medicine
    32. 32. The Power of Young People“The youth arethe hope of the Fatherland.” Dr. Jose Rizal National Hero of the Philippines
    33. 33. Fathers of Social Medicine
    34. 34. Health for All!Alma Ata, USSR, 1978 Almaty, Kazakhstan, 2008 Thank You Very Much!

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