Social determinants of health

Closing the gap in a generation - how?


Measure and understand the problem and assess the impact of action

Action on the social determinants of health will be more effective if basic data systems, including vital registration and routine monitoring of health inequity and the social determinants of health, are put in place so that more effective policies, systems and programmes can be developed. Education and training for relevant professionals is vital.

Who should be doing what?

While the Commission advocates strongly the central role of government and the public sector in taking action, it also recognises the need for support and action across the field – global institutions and agencies, governments themselves (national and local), civil society, research and academic communities, and the private sector.

Multilateral agencies

The Commission calls for coherence between sectors in policy-making and action to achieve improvements in health equity. The Commission calls on multilateral specialist and financing agencies to:

  • adopt health equity as a fundamental shared goal, and use a common global framework of indicators to monitor development progress;
  • ensure that increases in aid and debt relief support coherent social determinants of health policy-making and action among recipient governments;
  • support equitable participation of Member States and other stakeholders in global policy-making. adopt health equity as a fundamental shared goal, and use a common global framework of indicators to monitor development progress;
  • ensure that increases in aid and debt relief support coherent social determinants of health policy-making and action among recipient governments;
  • support equitable participation of Member States and other stakeholders in global policy-making.

WHO

WHO is the mandated leader in global health. It is time that WHO’s leadership role is enhanced through the agenda for action on the social determinants of health and global health equity. The Commission calls on WHO to:

  • adopt a stewardship role supporting social determinants of health capacity-building and policy coherence across partner agencies in the multilateral system;
  • support goal setting on health equity and monitor progress on health equity between and within countries as a core developmental objective through a global health equity surveillance system;
  • build internal social determinants of health capacity across WHO.

National and local government

Underpinning action on the social determinants of health and health equity is an empowered public sector, based on principles of justice, participation, and collaboration. Actions include: policy coherence across government; strengthening action for equity and finance; and measurement, evaluation, and training

Civil society

Civil society can play an important role in action on the social determinants of health. Actions include: participation in policy, planning and programmes; and evaluation and monitoring of performance.

Private sector

The private sector has a profound impact on health and well-being. Actions include: strengthening accountability; and investing in research

Research institutions

Knowledge – of what the health situation is; of what can be done about it; and of what works effectively to alter health inequity – is at the heart of the Commission. Actions include: generating and disseminating evidence on the social determinants of health.

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