Suchergebnisse

Action on the social determinants of health (SDH) is required to reduce inequities in health. This article summarises global progress, largely in terms of commitments and strategies. It is clear that there is widespread support for a SDH approach across the world, from global political commitment to within country action. Inequities in the conditions in which people are born, live, work and age, are however driven by inequities in power, money and resources. Political, economic and resource distribution decisions made outside the health sector need to consider health as an outcome across the social distribution as opposed to a focus solely on increasing productivity. A health in all policies approach can go some way to ensure this consideration, and we present evidence that some countries are taking this approach, however given entrenched inequalities, there is some way to go. Measuring progress on the SDH globally will be key to future development of successful policies and implementation plans, enabling the identification and sharing of best practice. WHO work to align measures with the sustainable development goals will help to forward progress measurement.

Purpose
– This paper was written as part of a suite to inform the Big Lottery Better Start programme and as such has focused on the outcomes that are of interest to that programme. The authors have also focused on outcomes for younger children and the zero to three years age group where data are available. There is a social gradient such that the lower a family's socio-economic status (SES) the greater the likelihood that they have children who are obese, have impaired social and emotional skills, or have impaired language acquisition. These statistics are clear and undisputed. The purpose of this paper is to explore some of the reasons for the social gradient in these outcomes. The paper provides some suggestions for actions that might be taken to redress the inequalities. It follows broader work presented in, for example, the Marmot (2010) review, Fair Society Healthy Lives.


Design/methodology/approach
– Rapid review of the literature building on the work of the Marmot (2010) review.


Findings
– Poor SES is linked with increased stress and a higher likelihood of being unable to afford to live a healthy life. These factors can have a negative impact on children's outcomes. The paper presents some examples of what can be done.


Originality/value
– This should be a useful paper for local authorities trying to reduce inequalities and improve outcomes.