There are several factors that determine our health, with access to social and economic facilities being the most prominent ones. The conditions in which people are born and the conditions in which they live, work and grow old can greatly affect an individual’s health. These factors have a direct impact on the quality and length of life besides having an influence on the possibilities of disability-free life.

In most of the cases, medical professionals only evaluate the proximate causes of diseases like smoking, obesity, altered lifestyle and alcohol. However, the actual ‘causes of causes’ are most of the times ignored, which constitute the root of all the medical ills. An effective social determinants approach includes far more than just focusing on proximate causes. It has to address what actually exacerbates premature ill health and the contributing factors.

The lower the people are positioned in the socioeconomic ladder, the more they tend to smoke, the more incomplete their diet is, and the less physical activity they engage in. Education seems to dominate all the other factors such as excessive alcohol consumption, taxation, price and availability, bans on advertising, smoking in public places and tobacco consumption.

Some examples of social determinants:

  • Access to and availability of resources to fulfil daily requirements such as shelter, food, clothes, etc.
  • Access to educational institutions, medical establishments, economic opportunities like jobs or any other source of earning
  • Access to quality medical facilities and healthcare services
  • Quality education, learning and knowledge
  • Availability of community-based resources like recreational and leisure-time activities
  • Daily-life facilities such as transportation and public safety options
  • Society’s attitude towards a person; for instance discrimination, racism or any other kind of bias
  • Prevailing conditions such as crime, violence, lack of cooperation in a community and social disorder
  • Socioeconomic conditions like concentrated poverty and other stressful conditions
  • Literacy and culture
  • Access to mass media and emerging technologies like cell phones, the Internet, and social media.

The world is going through a universal movement that seeks to address the inequalities in health and length of life through action on the social determinants of health. This movement has involved the World Health Organization, several national governments, civil society organization, and academics. Solutions are being sought and learnings shared.

WMA insists that doctors should be well-informed participants in this debate. The medical professionals can be advocates for action on the social conditions that affect health. The WMA agrees to add significant value to the necessary actions being taken:

  • By helping doctors, other health professionals and National Medical Associations understand what the emerging evidence shows and what works, in different circumstances
  • By helping doctors to press more effectively within their countries and across international borders, and ensure that medical knowledge and skills are shared
  • Gathering data of examples that are working, and helping engage doctors and other health professionals in trying new and innovative solutions
  • Educating and informing their members and putting pressure on national governments to take the appropriate steps for minimizing the root causes of premature ill health
  • Drawing up new action plans which include general practice that works across sectors to improve the quality of peoples lives and hence reduce health inequalities
  • Gathering examples of good practice from its members and promoting further work in this area.

[Source: WMA Declaration on Social Determinants of Health]