Monday, October 3, 2011

[EQ] Social determinants of health: practical solutions to deal with a well-recognized issue

Social determinants of health: practical solutions to deal with a well-recognized issue

Rüdiger Krech -  Department of Ethics, Equity, Trade and Human Rights, World Health Organization, Geneva, Switzerland
Bulletin of the World Health Organization 2011;89:703-703. doi: 10.2471/BLT.11.094870

Available online at:

“…..The call on governments to address the major challenge of health inequities which are determined by the social conditions in which people are born, grow, live, work, and age, is not new. The Commission on Social Determinants of Health worked on this. Its report re-enforces the message from the Ottawa Charter for Health Promotion, which itself was strongly rooted in the commitments made at the International Conference on Primary Health Care in Alma-Ata in 1978.1,2


The thinking behind the Alma-Ata Declaration, of course, dates back much further. Public health pioneers, such as Rudolf Virchow, Robert Koch and Oswaldo Cruz, had an in-depth knowledge of how social inequities relate to health outcomes.3 Robert Koch, for instance, devoted a key part of his Nobel Laureate speech in 1905 to the issue.4 And Brock Chisholm, the first Director-General of the World Health Organization, asserted in 1949 that “the death rate from pulmonary tuberculosis is now everywhere accepted as a sensitive index to the social state of a community.”5


Today, we know that this statement is not only true for tuberculosis but also for noncommunicable diseases, HIV/AIDS, malaria and other diseases. Reflecting that socio-cultural context is key to public health, the mandate for the World Health Organization to assist Member States in addressing the “causes of the causes” of ill-health is firmly rooted in its constitution.4….”



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