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The social determinants of health (SDOH) are the economic and social conditions and their distribution among the population that influence individual and group differences in health status. They are health promoting factors found in one's living and working conditions (such as the distribution of income, wealth, influence, and power), rather than individual risk factors (such as behavioural risk factors or genetics) that influence the risk for a disease, or vulnerability to disease or injury. According to some viewpoints, the distributions of social determinants are shaped by public policies that reflect the influence of prevailing political ideologies of those governing a jurisdiction. The World Health Organization says, "This unequal distribution of health-damaging experiences is not in any sense a 'natural' phenomenon but is the result of a toxic combination of poor social policies, unfair economic arrangements [where the already well-off and healthy become even richer and the poor who are already more likely to be ill become even poorer], and bad politics."
There is no single definition of the social determinants of health, but there are commonalities, and many governmental and non-governmental organizations recognize that there are social factors which impact the health of individuals.
In 2003, the World Health Organization (WHO) Europe suggested that the social determinants of health included:
In Canada, these social determinants of health have gained wide usage.
These SDOH are clearly related to health outcomes, are closely tied to public policy, and are clearly understandable by the public. They tend to cluster together – for example, those living in poverty also experience numerous other adverse social determinants. The quality and equitable distribution of these social determinants in Canada and the USA are clearly well below the standards seen in other developed nations.
The WHO later developed a Commission on Social Determinants of Health, which in 2008 published a report entitled "Closing the Gap in a Generation". This report identified two broad areas of social determinants of health that needed to be addressed. The first area was daily living conditions, which included healthy physical environments, fair employment and decent work, social protection across the lifespan, and access to health care. The second major area was distribution of power, money, and resources, including equity in health programs, public financing of action on the social determinants, economic inequalities, resource depletion, healthy working conditions, gender equity, political empowerment, and a balance of power and prosperity of nations.
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