From the Social to the Ultimate Determinants of Health

The notion that health is influenced by society, and the politics governing it, has been around for generations. The contemporary uptake of this idea can be found in the increasingly popular concept of ‘social determinants of health’. But should all social determinants be treated with equal concern? Or are certain determinants more important than others in influencing the health of populations?

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Labor Unions and Health

"Inside the Rotunda" Photo by Jessie Reeder, available under a Creative Commons Attribution-Noncommercial license.

Taking root in Wisconsin, the union battles that are sweeping across the Midwest are about more than pay, benefits and collective bargaining. Attacks on the rights of workers are also an attack on America’s health.

Factors like income, education and employment are important influences on the health of populations. The distribution of these resources is largely shaped by those with greatest political power.

Whereas US Republicans first argued that limiting union strength was necessary to keep government costs low, it is now well-known that these assaults have nothing to do with budget deficits and everything to do with diminishing the power of workers to collectively bargain.

For the past three decades, the power of labour and the working class has been declining in America (which currently has the lowest union membership density and lowest collective agreement coverage of any other developed nation). The resulting shift in wealth has given corporations and wealthy individuals greater control over the government and the policies it chooses to (or not to) pursue.

Specific policies supported by those in power have meant increasing job losses in the public sector, growing job insecurity, a weakening of regulatory protections and reduced safety nets and benefits. These conditions in turn, have led to major increases in social inequality, poverty, income inequality and social fragmentation, all fundamental determinants of heath.

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Research

Social Determinants of Health and Political Responsibility

By recognizing that health lies outside the medical system, US public health professionals acknowledge that health should no longer be defined as the responsibility of doctors. By accepting that health is amenable to political interventions, they should therefore also accept that its promotion becomes the responsibility of political actors.

USA

The Smoking Gun in Tucson Shooting? Income Inequality

On Monday, NPR’s On Point Radio was meant to host a show discussing how “inequality hurts societies”. The show was postponed however, in order to provide immediate coverage of the Tucson shooting incident. Ironically, a conversation about inequalities in societies could have brought some new perspective to the already redundant media commentaries which name violent political rhetoric, gun law, or the assassin’s mental health as sources of the tragedy.

Income Inequality

Interview with Exploring Equality: Lessons from Sweden

Inspired by the Spirit Level, two UK graduates cycle tour Sweden to find out what life is like in a more equal country. Through a series of video interviews the adventurists explore the ways in which the UK can learn from the Swedes. Excited about this project, I couldn’t help contacting Steven, recently returned from Sweden, for an interview.

Structural Determinants of Health

Policy Change from the Bottom-Up

Can collaboration with civil society organizations encourage action on the SDOH at the policy level? Just Health Action (JHA), a non-profit organization based in Seattle, Washington gives me hope.

Featured

An Alternative Route to Health Equity: A Second Bill of Rights

In the absence of a US health equity commission, how about a return to Roosevelt’s remedy for an ailing nation— FDR’s Second Bill of Rights would guarantee: The right to a useful and remunerative job in the industries or shops or farms or mines of the nation; The right to earn enough to provide adequate [...]

Structural Determinants of Health

RWJF Webinar: A new way to talk about the SDOH

Tune in Thursday July 29 at 2 pm Eastern Daylight Saving Time for a webinar presented by the Robert Wood Johnson Foundation titled “A new way to talk about the social determinants of health”. For more information and to register go here. var addthis_language = ‘en’;

Health Inequalities

Another Reason Why the Call to Action on Health Equity Remains Unanswered in the US

In May 2009, the World Health Assembly called on national governments to politically commit to tackle health inequities and to embrace the principles outlined in the final report of World Health Organization’s (WHO) Commission on Social Determinants of Health (CSDOH). In my last post, Healthy Policies looked at a recent Lancet debate over who owns [...]

Health Inequalities

Where is the US Commission on Health Equity?

In a quiet debate published by The Lancet, American public health researchers dispute “who owns health inequalities” , and what health-care reform legislation will do to reduce them. But are these researchers missing the proverbial forest for the trees? The conversation begins with a piece by Constance Nathanson (2010) which asserts, among other things, that [...]

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