The social determinants of health: Developing an evidence base for ...

Vivian Robinson, Sarah Simpson, Thelma Narayan,. Landon Myer, Tanja Houweling, Liliana Jadue, Francisca Florenzano. October 2007. The hub coordinating the Measurement and Evidence Knowledge Network is run by: Universidad del Desarrollo, Chile, and. National Institute for Health and Clinical Excellence, United ...
604KB Sizes 5 Downloads 138 Views
The social determinants of health: Developing an evidence base for political action

Final Report to

World Health Organization Commission on the Social Determinants of Health from

Measurement and Evidence Knowledge Network Michael P. Kelly (Co-chair) Josiane Bonnefoy (Co-chair)

Lead authors of final report: Michael P. Kelly, Antony Morgan, Josiane Bonnefoy, Jennifer Butt, Vivian Bergman

With Johan Mackenbach, Mark Exworthy, Jennie Popay, Peter Tugwell, Vivian Robinson, Sarah Simpson, Thelma Narayan, Landon Myer, Tanja Houweling, Liliana Jadue, Francisca Florenzano

October 2007 The hub coordinating the Measurement and Evidence Knowledge Network is run by: Universidad del Desarrollo, Chile, and National Institute for Health and Clinical Excellence, United Kingdom

Five key words for indexing purposes: Social determinants of health, health equity, evidence into policy, evidence into practice, inequalities/ inequities in health. Statement on conflict of interest We declare that we have no conflict of interest.

ertaken as work for the Measurement and Evidence Knowledge Network established asThis part work of the was WHOmade Commission the Social Determinants Health. The views possibleonthrough funding providedofby the World Health presented in this report are those of the authors and do not necessarily represent the Organization (WHO) and undertaken as work for the Measurement and Evidence Knowledge Network established part of the WHO Commission on the Social decisions, policy or views of WHO as or Commissioners. Determinants of Health. The views presented in this report are those of the authors and do not necessarily represent the decisions, policy or views of WHO or Commissioners.

The authors would like to thank Somsak Chunharas, John Lynch, Carlos Silva, Cesar G Victora and Michael C Wolfson for their peer reviews of this report. The authors are also grateful for comments received both on the MEKN scoping paper and the draft final report from Knowledge Network colleagues Ted Schrecker and Ron Labonte (Globalization) and Piroska Ostlin and Gita Sen (Women and Gender Equity). The authors are very pleased to acknowledge our Measurement and Evidence Knowledge Network colleagues for their involvement in the network meetings and their contributions to and comments on the different pieces of work.

2

Contents Page i

Political briefing ......................................................................................................................... 7

ii

Abstract ........................................................................................................................................ 7

iii

Structure of this report ............................................................................................................. 8

1

The challenge of measurement and evidence about the social determinants of health........................................................................................................................................... 10 1.1 Conceptual and theoretical issues ................................................................................. 10 1.1.1 Causal pathways..................................................................................................... 10 1.1.2 The difference between the causes of health and the causes of health inequities.................................................................................................................. 11 1.1.3 Accuracy of descriptions of the social structure ................................................. 12 1.1.4 Context ..................................................................................................................... 13 1.1.5 Nature of health inequity gradients ...................................................................... 14 1.1.6 Translation of knowledge into action..