Overcoming social and health inequalities among
—Challenges to the nation's health in the 21st century
Shahul H. Ebrahim, , , John E. Anderson , , Rosaly Correa-de-Araujo , , Samuel F. Posner , and Hani K. Atrash ,
aCenters for Disease Control and Prevention, Atlanta, GA, USA
bAgency for Healthcare Research and Quality, Rockville, MD, USA
cUS Department of Health and Human Services, USA
Health Policy (2008), doi:10.1016/j.healthpol.2008.09.011
Available online 21 November 2008. Health Policy
To frame the discussion of the nation's health within the context of maternal and child health.
Methods We used national data or estimates to assess the burden of 46 determinants.
Results During 2002–2004,
At least three-fourths of the
“……..We have shown that both supply and demand obstacles and macrosocial issues overwhelm the efforts to improve health of women and children in the
At the supply level, preconception care is preventive medicine for maternal and child health, and increasing its universal availability should be a national priority.
At the individual level, healthy lifestyle messages may be more meaningful when presented with its intergenerational benefits and in a supportive social environment. Individual level efforts should begin in childhood, incorporated into the school curricula and school activities.
At the policy level, as has been suggested at the global level (http://www.who.int/entity/social_determinants/final_report/csdh_finalreport_2008.pdf ) greater emphasis should be given to macrosocial determinants of health also in the
2.1. Data sources
2.3.1. Macrosocial determinants
2.5. Data limitations
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