Friday, November 11, 2011

[EQ] Social Determinants of Health - What Doctors Can Do

Social Determinants of Health – What Doctors Can Do

British Medical association BMA - October 2011

Available online PDF [28p.] at:


“…………Doctors worldwide recognise the importance of health inequalities. Historically many considered the main reason to be lesser access to health care, and concentrated on improving access. They now know this is only part of the picture. Today they are increasingly aware of the social gradient and its impact, as well as the impact this should have on the targeting of care and ill health prevention.

They recognise that health inequalities are related to structural determinants such as age, income, education, occupation, gender, ethnicity and place of residence. Many feel unable to make effective changes to any of these for their patients and their communities and are often frustrated by their inability to make a difference. Such despondency is unnecessary as there is much that is already being done, and can be built on, by doctors and their teams. In England health and life expectancy are steadily improving, but the poorest, the lowest socio-economic groups, are improving the least and differences across the gradient are increasing; doctors are seeking ways to reduce the gradient.

The magnitude of the social gradient in health is not fixed; it varies between countries and, indeed, within regions in Britain. Such variation shows that, in principle, it should be possible to attain the level of the best. While gradients between countries are not the major focus of this report they do need attention. It is worthy of note that the social gradient exists in all countries, even the poorest, but the slope of the gradient and therefore the scale of inequalities is amenable to action.

This paper will set out, very briefly, some of the evidence and examples of actions that doctors can take to affect the social determinants of health and reduce the social gradient. We hope that doctors will use the examples in this report to effect change themselves.

We recognise that not every doctor has the opportunity to change the social determinants of health throughout the life course of individual patients and have thus included other ways in which they can make a difference, as doctors working as community leaders…………”


What are the Social Determinants of Health?

Why should this be a concern of doctors?

Practising Holistic Medicine

The interaction of social factors

Unemployment and Poverty


Ill health prevention strategies

The NHS as an employer

What can doctors do? (including action grid to help inform activity)




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