WHO Report - Social determinants approaches to public health

WHO published a report related to social determinants approaches to public health. The health of a population is measured by the level of health and how this health isdistributed within the population. The WHO publication from early 2010, entitled Equity,social determinants and public health programmes analysed from the perspective of thirteen priority public health conditions their social determinants and explored possible entry points for addressing the avoidable and unfair inequities at the levels of socioeconomic context, exposure, vulnerability, health-care outcome and social consequences. However, the analysis needs to go beyond concepts to explore how the social determinants of health and equity can be addressed in the real world. This publication takes the discussion on social determinants of health and health equity to a practical level of how programmes have actually addressed the challenges faced during implementation.

The report does not provide a one-size-fits-all blueprint for success; rather, it analyses from different perspectives and within different contexts programmatic approaches that led to success or to failure. The final chapter synthesizes these experiences and draws the combined lessons learned. These lessons include: the need for understanding equity as a key value in public health programming and for working not only across sectors but also across health conditions. This requires a combination of visionary technical and political leadership, an appreciation that long-term sustainability depends on integration and institutionalization, and that there are no quick fixes to public health challenges. Programmes must get out of their comfort zones and, in addition to applying traditional biomedical and programmatic tools, they have to learn to address the economic, social, cultural and political realities in which public health conditions and inequities exist.

A common lesson learned from all the analysed cases is to not wait to identify what went right or wrong until after the programme has elapsed or failed. Research is a necessary component of any implementation to routinely explore, gauge, and adjust strategies and approaches in a timely manner.

The WHO report is available here.