5. Social determinants of health
Employment
conditions
Social
exclusion
Early child
development
Globalization
Health
systems
Measurement
and evidence
Urbanization
Women and
gender equity
Priority public
health condition
7. Inequality/Inequity
Health inequality : difference in health of
individuals or groups
Health inequity : systematic differences in
health that could be avoided by reasonable
means
Health inequity are not inevitable. They are
unjust and the product of unfair social,
economical and political agreements.
9. Brief History
United Nations General Assembly’s Universal
Declaration of Human Rights
1948
2000 Millennium Development Goals
2005 Commission on Social Determinants of Health
2016 Sustainable Development Goals
10. Medicine is a social science and politics is nothing else
but medicine on a large scale. Medicine as a social
science, as the science of human beings, has the obligation
to point out problems and to attempt their theoretical
solution; the politician, the practical anthropologist, must
find the means for their actual solution
Rudolf Virchow
15. Global Actions
WHO Commission on Social Determinants of
Health
although health inequities are increasing both within
and between countries, they are not inevitable, but
rather the result of policy failures.
living conditions
inequitable
distribution
understand problem
assess action’s impact
16. To adopt better governance for health and
development
To promote participation in policy-making and
implementation
To further reorient the health sector towards
reducing health inequities
To strengthen global governance and collaboration
To monitor progress and increase accountability
WHO respond - The Rio Political Declaration
40. Take Home Message
Health inequity
Social determinants are made up of half of
health and limit the opportunities of health
41. References
Arcaya MC, Arcaya AL, Subramanian SV
et al. Inequalities in health: definitions,
concepts, and theories. Glob Health
Action. 2015 Jun 24;8:27106.
WHO Social determinants of health
Editor's Notes
. 1948年聯合國大會提出健康是人權 ->影響許多國家憲法、國際條約、國內法與國家政策->健康的獨特價值
. 之後健康平等也漸漸被強調，2005 WHO成立Commission on Social Determinants of Health->確認健康平等是優先事項
此commisions蒐集與整合世界上社會決定因素影響健康的證據，並提出建議行動
. 再來到聯合國也強調健康平等的重要
In its Report to the World Health Assembly in 2009, the WHO Commission on Social Determinants of Health observed that, although health inequities are increasing both within and between countries, they are not inevitable, but rather the result of policy failures. The report gathered evidence on social determinants and ways to overcome health inequities and on actions to address them. It made three main recommendations:
improve daily living conditions;
tackle the inequitable distribution of power, money and resources; and
measure and understand the problem and assess the impact of action.
Specifically for WHO, the Commission recommended work in three areas:
strengthen global and national capacities to address social determinants, including providing support for a “health in all policies” approach, and to assess the impacts of global polices on health inequities;
strengthen efforts to measure and evaluate health inequities, through national health-equity surveillance systems and appropriate tools; and
build internal capacity to address social determinants and health inequities.
The Rio Political Declaration will help build national and international momentum for action around the following 5 key themes:
To adopt better governance for health and development
To promote participation in policy-making and implementation
To further reorient the health sector towards reducing health inequities
To strengthen global governance and collaboration
To monitor progress and increase accountability
