1 / 23

Taking a social determinants approach to NCD Control What do we know? What can we do?

This article discusses the importance of addressing inequities in non-communicable disease (NCD) control and the role of social determinants of health (SDH). It provides examples of how to address these determinants and promote health equity.

abelj
Download Presentation

Taking a social determinants approach to NCD Control What do we know? What can we do?

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Taking a social determinants approach to NCD ControlWhat do we know? What can we do? Anand Sivasankara Kurup Department of Ethics, Equity, Trade and Human Rights WHO, Geneva sivasankarakurupa@who.int 07 Sepember 2011

  2. Outline • Why address inequities? • What are the social determinants of health? • SDH and NCDs • What can be done? • Addressing social determinants in delivery of interventions • Addressing social determinants through intersectoral action • Conclusion

  3. What are inequities? Unfair, avoidable and remediable differences in health between groups

  4. What are the social determinants of health (SDH)? The circumstances in which people are born, grow up, live, work and age, and the systems put in place to deal with illness. A girl in Lesotho is likely to live 42 years less than another in Japan.

  5. Inequities in diabetes in China Source: QIAN R-L et al, Chinese Diabetes Journal (Chinese National Diabetes Survey 1996), courtesy G.Galea

  6. Asthma mortality in Sri Lanka 1999-2003 Source: RP Rannan-Eliya, Institute for Health Policy computations.

  7. by socio-economic group and country level of economic development Source: David et al in Blas E, Sivasankara Kurup eds. Equity, social determinants and public health programmes. Geneva: WHO; 2010: 199-217. • In low income countries, the difference between Q1 & Q5 is two times, where as in upper middle income countries, the difference is not very significant

  8. Why address inequities? • They are unfair and avoidable • Without doing so, major public health targets cannot be achieved • We know more about causes and how to address inequities

  9. Public health programmes need to address social determinants and health equity

  10. Treatment of hypertension in Chile Men-Women % BP under control Goes for treatment Courtesy J.Vega Awareness about the condition Population with hypertension

  11. Treatment of colon cancer in NZ • Maori patients • less likely to undergo extensive lymph node clearance • more likely to die during the postoperative period • less likely to receive chemotherapy for stage III disease • more likely to experience a delay of at least 8 weeks before starting chemotherapy Source: Hill S et al, Cancer Journal, 2010, available online doi:10.1002/cncr.25127

  12. What can be done about inequities? Measurement of differential performance along continuum of care Addressing points that cause inequities in health systems Linking to action on social determinants at local and municipal levels Providing information about inequities in health system and social determinants at local level Need disadvantaged groups to progress more rapidly than advantaged

  13. Health in All Policies “…government objectives are best achieved when all sectors include health and well-being as a key component of policy development…” Adelaide Statement on Health in All Policies, 2010

  14. Examples of Health in All Policies • Tobacco control • Urban planning • Cash transfers and social protection • Regulation of energy dense, low nutrition food • Environmental protection • Early child development • Employment and education policies • With equity lens

  15. Social determinants in health programmes: framework for analysis http://whqlibdoc.who.int.ezproxy.auckland.ac.nz/publications/2010/9789241563970_eng.pdf

  16. Social determinants occurring on the pathways of six or more conditions

  17. Entry-points, interventions and movers at the socioeconomic context and position

  18. Entry-points, interventions and movers at the differential exposure level

  19. Entry-points, interventions and movers at the differential vulnerability level

  20. Entry-points, interventions and movers at the differential health care outcomes level

  21. Entry-points, interventions and movers at the differential consequences level

  22. Conclusion Health inequities in NCD are avoidable and remediable Addressing inequities will contribute significantly to make progress on NCD targets NCD programme managers can: Measure inequities in NCD and disseminate this knowledge Act to ensure their own programmes do not worsen inequities Design interventions on risk factors considering social determinants Look to achieve greater progress for disadvantaged groups Advocate for broader intersectoral policies to address the social determinants

More Related