Social determinants of health

Country Work Stream 2005-2008

The Commission on Social Determinants of Health (CSDH) included a stream of work focused on country action to address socially determined health inequities. The so-called "Country Work Stream"engaged the "how-to" challenges countries face in turning evidence on the social determinants of health (SDH) and health equity (HE) into effective policies. The Country Work activities aimed to:

  • Support CSDH countries in advancing action on SDH and HE in their specific contexts, while
  • Enabling the CSDH to incorporate countries’ experiences in its learning and recommendations;
  • Provide WHO with an overview of the important issues to internalize for supporting the implementation of the SDH and HE agenda.

Key insights - how to get started on the SDH and HE agenda

  • How can country actors catalyze action at the national level?
  • What can the health sector do to promote an SDH and HE agenda internally?
  • What should the health sector be doing about intersectoral/cross-sectoral action on socially determined health inequalities?
  • How can Ministries of Health improve social participation on SDH/HE?
  • What kinds of capacities and skills need development to strengthen SDH/HE action, and how can the health sector build capacity?

The process

Country work was organized around:

The Country Work Stream engaged a small number of countries to champion the social determinants of health and health equity in all the above mentioned areas. Countries became engaged through a self-selection process, which was defined by the Commissioners.

The final report

This report organizes learning from the Country Work process according to five major questions countries had to face as they advanced national SDH agendas. These questions, and the solutions found by Country Partners, will be relevant to other countries seeking to tackle SDH in the future.

A key finding of the Country Work process is that countries can make significant progress in political action to tackle the social determinants of health inequities in a short time, such as the three year lifespan of the CSDH.

The way forward