Action on the social determinants for advancing health equity in the time of COVID-19: perspectives of actors engaged in a WHO Special Initiative

Abstract

Since the 2008 publication of the reports of the Commission on Social Determinants of Health and its nine knowledge networks, substantial research has been undertaken to document and describe health inequities. The COVID-19 pandemic has underscored the need for a deeper understanding of, and broader action on, the social determinants of health. Building on this unique and critical opportunity, the World Health Organization is steering a multi-country Initiative to reduce health inequities through an action-learning process in ‘Pathfinder’ countries. The Initiative aims to develop replicable and reliable models and practices that can be adopted by WHO offices and UN staff to address the social determinants of health to advance health equity. This paper provides an overview of the Initiative by describing its broad theory of change and work undertaken in three regions and six Pathfinder countries in its first year-and-a-half. Participants engaged in the Initiative describe results of early country dialogues and promising entry points for implementation that involve model, network and capacity building. The insights communicated through this note from the field will be of interest for others aiming to advance health equity through taking action on the social determinants of health, in particular as regards structural determinants.

Decision-support tools to build climate resilience against emerging infectious diseases in Europe and beyond

“…In that sense, the social determinants of health are important to take into account because they are key to understanding the distribution of infectious diseases and their related factors. 15 Therefore, indicators that monitor climate-sensitive infectious diseases should account for these complex interactions and their respective contribution to the risk of infectious disease geographical emergence, transmission and spread. To meet these evolving challenges in the preparedness and response to climate-sensitive infectious diseases, a paradigm shift is required that addresses animal, human, and environmental health in an integrated, unifying approach (i.e., using the One Health perspective), 16 , 17 as opposed to siloed approaches (i.e., ones that are focused solely on human health, or on climate risk).…”

Integration of Population Health, Social Determinants, and Social Justice in Transcultural Nursing and Culturally Competent Care: White Paper by the Scholars Education Interest Group

“…In 2008, the World Health Organization's (WHO) Commission on Social Determinants of Health published synthesized evidence on the causes of health inequities that set in motion generation of new knowledge and theories on the social determinants of health (SDOH; Solar et al, 2022). The ongoing COVID-19 pandemic has exemplified how structural determinants of health inequity have real impacts on differences in infection rates, access to treatment, and mortality (WHO, 2021).…”

“…The dominant ethos of individualism underlying the belief that individuals can be relied upon to act on their behalf creates an impossible expectation for population groups with multiple social vulnerabilities to tackle systemic societal structures and policies that limit their ability for self-agency (Krieger, 2021). Actions on social determinants necessitate broad-based multisectoral collaboration to create high-impact solutions and theories of change to dismantle unfair policies, laws, and regulations that limit the potential including health of vulnerable groups (Solar et al, 2022).…”

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“…Globally issued guidelines often fail to reflect the diversity of circumstances that persons with disabilities face and how these may be redressed through ensuring availability of data and participation from these communities. The paper by Solar, Valentine and colleagues [ 8 ] presents a WHO special initiative that has sought to theorise on how action on social determinants of health may move forward, focusing on building models for change, building networks for collaboration and building capacity to think and act across sectors. There is a long way to go to make a transformative change that brings about health equity on the ground, but the commitment and threads of collaboration have emerged.…”