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Social Determinants of Health

Social Determinants of Health. Dr Rüdiger Krech Director, WHO Department of Ethics, Equity, Trade and Human Rights. Why treat people. then send them back to the conditions that made them sick?. Outline. What are the social determinants of health? What is WHO doing about it?

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Social Determinants of Health

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  1. Social Determinants of Health Dr Rüdiger Krech Director, WHO Department of Ethics, Equity, Trade and Human Rights

  2. Why treat people ... then send them back to the conditions that made them sick?

  3. Outline • What are the social determinants of health? • What is WHO doing about it? • How can health communicators contribute? • Q&A and further discussion…

  4. What are the social determinants of health (SDH)? The circumstances in which people are born, grow up, live, work and age, and the systems put in place to deal with illness. A girl in Lesotho is likely to live 42 years less than another in Japan.

  5. What are inequities? The unfair, unjust and avoidable causes of ill health

  6. What then influence the SDH and inequities? "(The) toxic combination of bad policies, economics, and politics is, in large measure responsible for the fact that a majority of people in the world do not enjoy the good health that is biologically possible,” -WHO Commission on the Social Determinants of Health

  7. Life expectancy at birth (men) (WHO World Health Report 2006; Hanlon,P.,Walsh,D. & Whyte,B.,2006)

  8. Outline • What are the social determinants of health? • What is WHO doing about it? • How can health communicators contribute? • Q&A and further discussion…

  9. Commission on Social Determinants of Health • Improve Daily Living Conditions • 2. Tackle the Inequitable Distribution of Power, Money, and Resources • 3. Measure and Understand the Problem and Assess the Impact of Action.

  10. WHO Streams of Work • Intersectoral action/ “health in all policies” • Addressing social determinants in public health programmes • Measuring health inequities and monitoring impact of policies on inequities

  11. Health in All Policies “government objectives are best achieved when all sectors include health and well-being as a key component of policy development” -Adelaide Statement on Health in All Policies, 2010.

  12. Health as a resource for broader government goals

  13. Health sector responsibilities • Understanding the political agendas and administrative imperatives of other sectors; • Building the evidence base of policy options and strategies; • Assessing comparative health consequences of options within the policy development process; • Creating regular platforms for dialogue and problem solving with other sectors; • Evaluating the effectiveness of intersectoral work and integrated policy-making.

  14. SDH within health programs • Few global targets (e.g. MDGs) will be met without addressing social determinants • A social determinants approach mean moving out of comfort-zones to work across sectors • Communication of programmes should focus on supporting a critical public policy dialogue • Equity is a matter of how resources [and power] are distributed - all programmes and societies can afford to be more equitable.

  15. Global Plan: Tb eliminated by 2050 10000 Current trend (0.5%) extrapolated 1000 Global Plan prediction: incidence falls 5-6% per year 100 Incidence/million/yr 10 Desired trend Elimination target: 1 / million / year by 2050 1 1990 2000 2010 2020 2030 2040 2050

  16. PH programmes need to address the SDH and health equity Beneficiaries Adherers Participants Total reached Target Population Total Population Population not benefitting

  17. Social determinants in health programmes: framework for analysis Organized the work along a common framework Three phases Analysis Interventions and implications Measurement

  18. Outline • What are the social determinants of health? • What is WHO doing about it? • How can health communicators contribute? • Q&A and further discussion…

  19. How does communication affect SDH? • Discovers and reports the “causes of the causes” • Holds bureaucrats and policy/makers accountable for equitable outcomes • Is a platform for civil society voice

  20. Questions for health bureaucrats and policy/makers • How are you living up to your responsibility to address broader social issues? • Does this programme/policy combine equity, effectiveness and efficiency goals? • What is your plan to increase equity despite fiscal constraint?

  21. Outline • What are the social determinants of health? • What is WHO doing about it? • How can health communicators contribute? • Q&A and further discussion…

  22. Conclusion • The majority of factors that contribute to ill health and health inequities lie outside the traditional mandate of the health sector • The social determinants of health must be considered within health programmes and across government policies in order to reach broader societal • Policy-makers and bureaucrats must be held accountable for reducing health inequities

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