Addressing social determinants of health inequities: what can the state and civil society do?

Complexity and health – yesterday's traditions, tomorrow's future

“…In this context, we wholeheartedly agree with Isabelle Stengers [25] who emphasized emphatically that the discovery and study of surprising phenomena -like the observation that more intensive glucose control increases mortality [26] or increasing the dose of chemotherapy not improving therapeutic response or survival [27] or the large investment in health services not being matched by a similar magnitude of improvement in inequity between social classes [28] -should not result in a rupture inside the medical sciences, but rather create the opportunity to entertain a different relationship with our past approaches -highlighting 'openness, surprise, the demand of relevance, the creative aspect of the scientific adventure, and not reduction to simplicity. ' The intellectual challenges that researchers experience in medicine and health services at the beginning of the 21st century are no different to those experienced by researchers like Gallileo and [26] response to coumadin-therapy increasing the dose of chemotherapy does not improve therapeutic response or survival [27] chemotherapy initially reduces tumour size but also includes the promotion of secondary tumours [34] large investment in health services has not been matched by a similar magnitude of improvement in inequity between social classes [28] the introduction of electronic prescribing systems had mixed impacts on appropriateness and safety of prescribing and patient health outcomes [35,36] Open to environment…”

“…' The intellectual challenges that researchers experience in medicine and health services at the beginning of the 21st century are no different to those experienced by researchers like Gallileo and [26] response to coumadin-therapy increasing the dose of chemotherapy does not improve therapeutic response or survival [27] chemotherapy initially reduces tumour size but also includes the promotion of secondary tumours [34] large investment in health services has not been matched by a similar magnitude of improvement in inequity between social classes [28] the introduction of electronic prescribing systems had mixed impacts on appropriateness and safety of prescribing and patient health outcomes [35,36] Open to environment…”

Economic, Legal, and Social Hardships Associated with HIV Risk among Black Men who have Sex with Men in Six US Cities

“…12,[45][46][47] Further research is needed to better understand how hardship conditions affect HIV risk for Black MSM, including exploring intersections between measures of various types and levels of hardships. Future research can build on these results by exploring whether individual-level hardships interact with area-level hardships to predict HIV risk in Black MSM and what is the impact of geo-political location on these associations.…”

“…11 Cities are important geographic contexts to study in relation to hardships and HIV risk since the US HIV epidemic is concentrated in urban areas, and cities are sites where many economic, legal, and social policies are implemented and enforced and local health inequities produced. 12,13 Geographic context is also not limited to physical location but incorporates perspectives on the ways in which structural level inequities, within those geographic contexts, contribute to the production of HIV risk. 14,15 The purpose of this study was to test the hypothesis that economic, legal, and social hardships were associated with increased odds of HIV risks in a non-probability sample of Black MSM.…”

Public Health Ethics: Global Cases, Practice, and Context

“…But a major milestone was reached with the 2008 report of the WHO Commission on Social Determinants of Health that sought to "marshal the evidence on what can be done to promote health equity , and to foster a global movement to achieve it" (WHO 2008 ). Although governments can guarantee human rights and essential services, establish policies that provide an equitable basis for health improvement, and gather and monitor data on health equity , achieving equity ultimately will depend on the cooperation of government and civil society (Blas et al 2008 ).…”