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| BOOK REVIEW |
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| Year : 2009 | Volume
: 22
| Issue : 2 | Page : 381 |
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Closing the Gap in a Generation - Health Equity through Action on the Social Determinants of Health
KE Peters1, SM Cristancho2, DM Garces3
1 University of Illinois at Chicago, School of Public Health, USA
2 Facultad Nacional de Salud Publica, Universidad de Antioquia, Colombia
3 Departamento de Medicina Preventiva y Salud Publica, Facultad de Medicina, Universidad de Antioquia, Colombia
| Date of Web Publication | 8-Jan-2013 |
Correspondence Address:
K E Peters
University of Illinois at Chicago, School of Public Health
USA
 Source of Support: None, Conflict of Interest: None  | Check |
How to cite this article:
Peters K E, Cristancho S M, Garces D M. Closing the Gap in a Generation - Health Equity through Action on the Social Determinants of Health. Educ Health 2009;22:381 |
Closing the Gap in a Generation - Health Equity through Action on the Social Determinants of Health
Commission on Social Determinants of Health
World Health Organization (2008)
248 pp. ISBN 978 92 4 156370 3
Available at: http://whqlibdoc.who.int/publications/2008/9789241563703_eng.pdf
The long anticipated landmark report entitled Closing the Gap in a Generation, Health Equity through Action on the Social Determinants of Health was released on the 28th of August in 2008 in Geneva, Switzerland, by Dr. Margaret Chan, Director- General of the World Health Organization (Commission on Social Determinants of Health). The report is the result of a three-year study conducted under the auspices of the Commission on Social Determinants of Health. The Commission was chaired by Sir Michael Marmot and included the input of hundreds of experts on global health worldwide.
At the press conference launch of the report, Dr. Chan stated that the major finding of the study was: "The social conditions in which people are born, live, and work are the single most important determinant of good health or ill health, of a long and productive life, or a short and miserable one." The report makes clear that it is the upstream 'causes of the causes' or factors in our social environments that often determine our lifestyle behaviors and access to healthcare which, in turn, can determine our life expectancies and health outcomes. The report clearly highlights the need for a 'prevention' orientation in which policies and programs are designed to address the causes of social deprivation. In fact, the report calls for all public policies to include an assessment of 'health impact' before being implemented. Simple policy changes oriented to health development such as income redistribution through targeted social programs and taxation systems that are progressive have demonstrated great success in reducing poverty and improving health status in communities and countries alike.
The report itself is over 250 pages long (English version) and is available online (in PDF format) in Arabic, Chinese, French, Russian and Spanish. The Executive Summary is also available in Hungarian, Slovakian, Slovenian and Swedish. There are a total of 17 chapters divided into six parts. The overarching recommendations of the report are: 1) Improve daily living conditions; 2) Tackle the inequitable distribution of power, money and resources; and 3) Measure and understand the problem and assess the impact of action.
It is important to note that the Commission's report is complementary to the other major health development initiative known as the Millennium Declaration which declares "Those who suffer or benefit least deserve help from those who benefit most." The Declaration was the basis for the creation of the Millennium Development Goals which aim to address the root causes of poverty and poor health through multi-sector linkage and action (UN Millennium Project, 2005). Both of these efforts are rooted in the principles of global social justice, namely, to ensure that globalization is both inclusive and equitable for all the world's citizens. The strategies advocated in both documents focus attention on the key complementary roles of primary care and community-based participatory action approaches for understanding and improving health worldwide (Cristancho et al., 2008; Peters et al., 2004).
"A girl born today can expect to live for more than 80 years if she is born in some countries - but less than 45 years if she is born in others. Within countries there are dramatic differences in health that are closely linked with degrees of social disadvantage. Differences of this magnitude, within and between countries, simply should never happen" (from the Commission's Executive Summary, Closing the Gap in a Generation).
The report provides us with a challenge and a blueprint for action to achieve health equity in a generation. The Network: Towards Unity for Health and Education for Health can continue to contribute to accomplishing this goal!
Reviewed by:
Karen E. Peters, DrPH
Assistant Professor of Health Policy and Administration
University of Illinois at Chicago, School of Public Health
USA
Sergio Cristancho Marulanda, PhD
Visiting Professor
Facultad Nacional de Salud Publica
Universidad de Antioquia, Colombia
D. Marcela Garces, MD, MSPH
Assistant Professor
Departamento de Medicina Preventiva y Salud Publica
Facultad de Medicina
Universidad de Antioquia, Colombia
Useful Resources
United Nations Department of Public Information (2008). Millennium Development Goals. Retrieved July 30, 2009, from http://www.un.org/millenniumgoals/
Wikipedia (2009). Social Determinants of Health. Retrieved July 30, 2009, from http://en.wikipedia.org/wiki/Social_determinants_of_health
World Health Organization (2008). Commission on Social Determinants of Health. Retrieved July 30, 2009, from http://www.who.int/social_determinants/en/
References
Commission on Social Determinants of Health. (2008). Closing the Gap in a Generation: Health Equity through Action on the Social
Determinants of Health. Geneva: World Health Organization. Available at: http://whqlibdoc.who.int/ publications/2008/9789241563703_eng.pdf
Cristancho, S., Garces, DM., Mueller, B., & Peters, K. (2008). Listening to rural Hispanic communities in the Midwest: A focus groups
assessment of perceived barriers to access healthcare. Qualitative Health Research, 18(5), 633-646.
Peters, K. & Henley E. (2004). Acting on synergies between clinic and community strategies to improve preventive medicine. Journal of Family Practice, 53(12), 970-973
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