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The gross inequalities in health that we see within and between countries present a challenge to the world. That there should be a spread of life expectancy of 48 years among countries and 20 years or more within countries is not inevitable. A burgeoning volume of research identifies social factors at the root of much of these inequalities in health. Social determinants are relevant to communicable and non-communicable disease alike. Health status, therefore, should be of concern to policy makers in every sector, not solely those involved in health policy. As a response to this global challenge, WHO is launching a Commission on Social Determinants of Health, which will review the evidence, raise societal debate, and recommend policies with the goal of improving health of the world's most vulnerable people. A major thrust of the Commission is turning public-health knowledge into political action.

Despite shame being recognised as a powerful force in the clinical encounter, it is underacknowledged, under-researched and undertheorised in the contexts of health and medicine. In this paper we make two claims. The first is that emotional or affective states, in particular shame, can have a significant impact on health, illness and health-related behaviours. We outline four possible processes through which this might occur: (1) acute shame avoidance behaviour; (2) chronic shame health-related behaviours; (3) stigma and social status threat and (4) biological mechanisms. Second, we postulate that shame's influence is so insidious, pervasive and pernicious, and so critical to clinical and political discourse around health, that it is imperative that its vital role in health, health-related behaviours and illness be recognised and assimilated into medical, social and political consciousness and practice. In essence, we argue that its impact is sufficiently powerful for it to be considered an affective determinant of health, and provide three justifications for this. We conclude with a proposal for a research agenda that aims to extend the state of knowledge of health-related shame.

Article ; This is the final version of the article. Available from BMJ Publishing Group via the DOI in this record. ; Despite shame being recognised as a powerful force in the clinical encounter, it is underacknowledged, under-researched and undertheorised in the contexts of health and medicine. In this paper we make two claims. The first is that emotional or affective states, in particular shame, can have a significant impact on health, illness and health-related behaviours. We outline four possible processes through which this might occur: (1) acute shame avoidance behaviour; (2) chronic shame health-related behaviours; (3) stigma and social status threat and (4) biological mechanisms. Second, we postulate that shame's influence is so insidious, pervasive and pernicious, and so critical to clinical and political discourse around health, that it is imperative that its vital role in health, health-related behaviours and illness be recognised and assimilated into medical, social and political consciousness and practice. In essence, we argue that its impact is sufficiently powerful for it to be considered an affective determinant of health, and provide three justifications for this. We conclude with a proposal for a research agenda that aims to extend the state of knowledge of health-related shame. ; The funding was from the Wellcome Trust Seed Award 201518/Z/16/Z.

On the concept of health capital and the demand for health -- The human capital model -- The correlation between health and schooling -- An exploration of the dynamic relationship between health and cognitive development in adolescence -- Parental education and child health : evidence from a natural experiment in Taiwan -- Women's education : harbinger of another spring? Evidence from a natural experiment in Turkey -- Variations in infant mortality rates among counties of the United States : the roles of public policies and programs -- Determinants of neonatal mortality rates in the U.S. : a reduced form model -- Birth outcome productions function in the U.S. -- Unobservables, pregnancy resolutions, and birthweight production functions in New York City -- The impact of national health insurance on birth outcomes : a natural experiment in Taiwan -- The effects of government regulation on teenage smoking -- Beer taxes, the legal drinking age, and youth motor vehicle fatalities -- Effects of alcoholic beverage prices and legal drinking ages on youth alcohol use -- Rational addiction and the effect of price on consumption -- An empirical analysis of cigarette addiction -- An empirical analysis of alcohol addiction : results from the monitoring the future panels -- The demand for cocaine by young adults : a rational addiction approach -- An economic analysis of adult obesity : results from the behavioral risk factor surveillance system -- Fast-food restaurant advertising on television and its influence on childhood obesity -- Food prices and body fatness among youths

We are concerned that providing insurance for the previously uninsured will be seen as a panacea for resolving health disparities, for the social environment makes a tremendous difference in health outcomes. A careful examination of the factors involved in the social determinants of health shows that health insurance plays only a small role in alleviating health disparities. In this commentary, we highlight the complexity of the problem of the social determinants of health and health disparities in the United States by comparing two neighborhoods in Baltimore City and by examining hypertension and mental health disorders.

Corporation-induced diseases are defined as diseases of consumers, workers, or community residents who have been exposed to disease agents contained in corporate products. To study the epidemiology and to guide expanded surveillance of these diseases, a new analytical framework is proposed. This framework is based on the agent–host–environment model and the upstream multilevel epidemiologic approach and posits an epidemiologic cascade starting with government-sanctioned corporate profit making and ending in a social cost, i.e., harm to population health. Each of the framework's levels addresses a specific level of analysis, including government, corporations, corporate conduits, the environment of the host, and the host. The explained variable at one level is also the explanatory variable at the next lower level. In this way, a causal chain can be followed along the epidemiologic cascade from the site of societal power down to the host. The framework thus describes the pathways by which corporate decisions filter down to disease production in the host and identifies opportunities for epidemiologic surveillance. Since the environment of city dwellers is strongly shaped by corporations that are far upstream and several levels away, the framework has relevance for the study of urban health. Corporations that influence the health of urban populations include developers and financial corporations that determine growth or decay of urban neighborhoods, as well as companies that use strategies based on neighborhood characteristics to sell products that harm consumer health. Epidemiological inquiry and surveillance are necessary at all levels to provide the knowledge needed for action to protect the health of the population. To achieve optimal inquiry and surveillance at the uppermost levels, epidemiologists will have to work with political scientists and other social scientists and to utilize novel sources of information.

The allegory of the orchard : The political determinants of health inequities -- Setting the precedent : America's attempts to address the political determinants of health inequities -- The political determinants of health model -- How the game Is played : successful employment of the political determinants of health -- Winning the game that never ends -- Growing pains : tackling the political determinants of health inequities during a regressive period -- The future of health equity begins and ends with the political determinants of health.

The commercial determinants of health are, broadly speaking, those activities of the private sector that affect the health of populations. These can be direct, such as the marketing of unhealthy products, or more distal, like industry lobbying against emissions regulations, or duty increases, donating to political campaigns, funding unreliable or misleading research aimed at generating doubt around product harms. The power and scale of commercial 'non-state' actors are vast in breadth and depth, and growing, with intersectional influence that spans our physical, social, and cultural environments. Yet there has been little effort to synthesize research on the potential negative aspects of this influence for population health. This gap does a disservice to society at a time when global problems, such as climate change, demonstrate the extent to which the influence and incentives of such non-state actors must be accounted for if progress is to be made. Studying the commercial determinants of health requires an understanding of the common elements and incentives that drive corporate strategy, and what their individual and cumulative effects are on health, policy, research and discourse. Commercial Determinants of Health is intended primarily as a comprehensive text that brings together cross-cutting ideas and evidence bases in a way that brings this field of study together, describes the state of the evidence and conceptual thinking, and considers its future direction and potential impact in light of this. The field of commercial determinants research remains one in progress, with early evidence of research funders taking interest on the broader consequences of commercial activity on health and policy, but no clear frameworks, courses, conferences, journals or books to support junior scholars as they move into this rapidly growing field. This is therefore the ideal time for a book that brings together past and recent evidence across a range of disciplines in a way that gives this field shape and direction, and in doing so becomes an important foundation for future research and translation efforts. The audience for this book includes scholars from a range of disciplines (including for example sociology, epidemiology, ethics, law and economics), readers with a general interest in the topic, advocates and public health practitioners. Therefore, we hope that the book can make a genuine scholarly contribution, but also be accessible so that readers from different disciplinary perspectives can still find the work readable and compelling.

More than half of the world's 100 largest economies are corporations and an increasing proportion of global deaths are caused by exposure to highly-processed foods, alcohol, tobacco, and air pollution. This chapter explores the full spectrum of commercial activities that impact human health, starting with the historical perspective and moving to consider the various frameworks that have been developed in the past decade to harness and address these commercial determinants. Numerous examples are used to illustrate the actions of industry groups to subvert health-focused policies and foster a narrative that solely blames individuals for harmful levels of consumption. Common industry tactics are dissected and practical rebuttals are presented to tackle ubiquitous arguments. This chapter also redresses the current harm-focused CDOH balance by considering the positive direct and indirect impact that commerce and corporations can exert through their operations, closing with a selection of simple rubrics that can be used to conduct quick and nuanced assessments of individual firms. In sum, this chapter introduces readers to the field of CDOH, covers the core concepts with the attending historical, political and philosophical background, and provides the tools required to engage in CDOH research and advocacy.

"Our health is to a large degree shaped by the world around us, that is to say, by the conditions in which we are born, grow, work, and live. As described in pivotal reports in recent years, most notably by the World Health Organization in its report on the social determinants of health in 2008,1 it is these conditions that are largely responsible for health and for the health inequalities observed within and between countries.2 Subsequent approaches informed by this understanding, such as Health in All Policies,3 or One Health,4 have sought to close health gaps through coordinated action on policy beyond health"--