Social determinants of health

Stories of positive action from around the world

Story numbers correspond to those in the Report.

Good global governance and health equity

15.1: Globalization – policy influences that can endanger health equity

The policy influences that can endanger health equity include: technological advances, leading to rapidly decreasing costs for transportation, communication, and information processing that, alongside institutional changes such as trade liberalization, facilitate the global reorganization of productive activity in ways that can enhance inequity; an increase in the value of foreign direct investment relative to trade, reflecting the growing interchangeability of direct investment and trade in the production and provision of goods and services; an increase in the importance of ‘off-shored’ or ‘outsourced’ production, often undertaken by independent contractors rather than subsidiaries or affiliates of a parent firm, frequently giving rise to poorer working conditions; a drastic increase in flows of hypermobile portfolio investment (‘hot money’), increasing the risk of currency crises; increased competition for investment and a consequent shift of power from local and national authorities to decision-makers in international financial markets, creating policy influence that may harm health equity. Source: GKN, 2007

15.5: Security Council reform

The Security Council reflects the global power structure of 1945, when most of today’s nations were still under colonial rule. In 1965, under pressure from a growing membership, the UN added four new elected members to the Security Council, bringing its total membership to 15. But the five principal Second World War allies clung to their privileged status. They remain ‘permanent’ and have the power to veto any Security Council decision. This arrangement makes the Security Council both undemocratic and ineffective. The five veto-wielding permanent members prevent many issues from reaching the Security Council’s agenda and they often selfishly bar widely agreed and much-needed initiatives. Despite the 10 elected members, the Security Council remains geographically unbalanced and seriously unrepresentative. Source.

15.10: The World Health Organization and UN-Habitat

UN-HABITAT and WHO have identified three relevant interventions to jumpstart a response from the health sector for healthy urbanization: an urban health equity assessment and response tool (Urban HEART) that enables ministries of health to track areas of rapid urbanization and monitor health inequity; a global report on urban health; and a joint UN-HABITAT/WHO global meeting on healthy urbanization to coincide with the biannual World Urban Forum of UN-HABITAT, possibly in 2010. There are also tools for reducing health inequity in urban settings, that is, a ‘social technology grid’ and a training module (the Healthy Urbanization Learning Circle) to link public health and community efforts at the municipal level. KNUS, 2007