Health as Freedom: Addressing Social Determinants of Global Health Inequities Through the Human Right to Development

Abstract

In spite of vast global improvements in living standards, health, and well-being, the persistence of absolute poverty and its attendant maladies remains an unsettling fact of life for billions around the world and constitutes the primary cause for the failure of developing states to improve the health of their peoples. While economic development in developing countries is necessary to provide for underlying determinants of health--most prominently, poverty reduction and the building of comprehensive primary health systems--inequalities in power within the international economic order and the spread of neoliberal development policy limit the ability of developing states to develop economically and realize public goods for health. With neoliberal development policies impacting entire societies, the collective right to development, as compared with an individual rights-based approach to development, offers a framework by which to restructure this system to realize social determinants of health. The right to development, working through a vector of rights, can address social determinants of health, obligating states and the international community to support public health systems while reducing inequities in health through poverty-reducing economic growth. At an international level, where the ability of states to develop economically and to realize public goods through public health systems is constrained by international financial institutions, the implementation of the right to development enables a restructuring of international institutions and foreign-aid programs, allowing states to enter development debates with a right to cooperation from other states, not simply a cry for charity.

Taking stock of the social determinants of health: A scoping review

“…Authors came from a variety of academic disciplines that included health-related disciplines such as public health,[64,78] population health,[26] nursing,[71] medicine,[79] social work,[80] epidemiology,[81] and social science disciplines, such as sociology,[9,69] sociomedical or social sciences,[21,33,82] geography,[18] governance,[83] social policy,[84] communication,[85] and economics. [22]…”

“…[103] Well-known examples of SDOH models, presented in chronological order, include Evans and Stoddart’s (1990) framework, which shows how individual and social factors interact outside of the health care system,[22] Whitehead and Dahlgren’s (1991) ‘rainbow model’ which shows concentric half-circles of influential social factors,[104] and more recently, Solar and Irwin’s (2007) conceptual model produced for the WHO that shows the multiple directions through which structural and intermediary determinants impact health and health equity. [16] Lesser known examples include Fox and Meier’s (2009) right to development SDOH model [21] and the model for Métis SDOH that shows interrelationships specific to this population (e.g., self-determination, land, colonization). [66] While numerous other models exist, they have been documented elsewhere [e.g., [20, 89, 93, 103, 105–106]] and will not be reviewed here.…”

El acceso a la salud como derecho humano en políticas internacionales: reflexiones críticas y desafíos contemporáneos

“…Fox & Meyer 24 relate social determinants of health, which they call the "right to development", with the human right to health. What is most striking about their proposal is not the fact that they associate the human right to health with social determinants of health, but rather that they situate this right within the relative inequalities produced by the unjust and unequal globalized neoliberal economic system.…”

Inequalities in health: the role of health insurance in Nigeria

“…Fox and Meier rightly stress that there is far more to be done in breaking the link between poverty and health than implementing programs which influence only one sector of the health system, and advocates a systemic intervention that focuses eradicating poverty through addressing all the underlying health determinants. 30 Nevertheless, in the words of the Director-General of the World Health Organization, Dr. Margaret Chan, in her address to the 65th World Health Assembly in Geneva in 2012: Universal health coverage is the single most powerful concept that public health has to offer. 12 Health insurance as an agent of financial inclusion is instrumental to the future success of the Nigerian public health system.…”