Social determinants of health

Evidence on social determinants of health

© Zoltan Balogh
Travellers on a Budapest public bus, Hungary, 2011

Evidence to support the case for addressing social determinants of health is divided into two types: The first relates to the five ‘Action Areas’ of the Rio Political Declaration on SDH, and which focuses on how to put in place processes to address the causes – for example, structural conditions – and consequences of ill-health. The second relates to themes (originally known as ‘Knowledge networks’), such as early child development, health systems, urbanization, and others.

Action Areas

In preparing for the World Conference on SDH, a number of a case studies and other research and analysis were conducted in order to provide the evidence base for the SDH approach, and which formed the basis of the Rio Political Declaration. This evidence is organized within the five ‘Action Areas’ of the Declaration.


During its tenure, the Commission on Social Determinants of Health focused on nine broad areas that contain within them major determinants of health. These key themes remain integral to the work of the WHO implementation strategy and global plan as it moves forward.

Evidence on themes

Employment conditions

Pierre Virot

Measures to clarify how different types of jobs and the threat of unemployment affect workers’ health.

Social exclusion

The relational processes that lead to the exclusion of particular groups of people from engaging fully in community and social life.

Priority public health conditions

Factors in the design and implementation of programs that increase access to health care for socially and economically disadvantaged groups.

Women and gender equity

Mechanisms, processes and actions that can be taken to reduce gender-based inequities in health by examining different areas.

Early child development

©Fran Baum
Children in Kibera slum, Nairobi

Well established evidence illustrates that opportunities provided to young children are crucial in shaping lifelong health and development status.


How globalization’s dynamics and processes affect health outcomes: trade liberalization, integration of production of goods.

Health systems

Innovative approaches that effectively incorporate action on social determinants of health.

Measurement and evidence

The development of methodologies and tools for measuring the causes, pathways and health outcomes of policy interventions.


Broad policy interventions related to healthy urbanization, including close examination of slum upgrading.