Research makes case for nurture over nature
The WHO Commission on the Social Determinants of Health has published findings from a fascinating investigation into health inequity.
A child born in one Glasgow inner-city community can expect a life 28 years shorter than another living in a suburb only 13 kilometres away. A girl in Lesotho is likely to live 42 fewer years than another in Japan. In Sweden, the risk of a woman dying during pregnancy and childbirth is one in 17,400 – in Afghanistan, the odds are one in eight.
Biology does not explain any of this. Instead, the differences between – and within – countries result from the social environment where people are born, live, grow, work and age.
These “social determinants of health” have been the focus of a three-year investigation by an eminent group of policymakers, academics, former heads of state and former ministers of health. Together, they comprise the World Health Organization’s Commission on the Social Determinants of Health.
But what do we do about it?
The Commission presented its findings to the WHO Director-General Dr Margaret Chan who, while welcoming the report and congratulating the Commission, said: “Health inequity really is a matter of life and death, but health systems will not naturally gravitate towards equity.
“Unprecedented leadership is needed that compels all actors, including those beyond the health sector, to examine their impact on health. Primary health care, which integrates health in all of government’s policies, is the best framework for doing so.”
See: Closing the gap in a generation: Health equity through action on the social determinants of health.