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PROGRESS ON COMMISSION ON SOCIAL DETERMINANTS OF HEALTH

PROGRESS ON COMMISSION ON SOCIAL DETERMINANTS OF HEALTH. Sir Michael Marmot Chair of the Commission on Social Determinants of Health. Key Messages. Social, economic and political circumstances affect life and well-being and health;

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PROGRESS ON COMMISSION ON SOCIAL DETERMINANTS OF HEALTH

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  1. PROGRESS ON COMMISSION ON SOCIAL DETERMINANTS OF HEALTH Sir Michael Marmot Chair of the Commission on Social Determinants of Health

  2. Key Messages • Social, economic and political circumstances affect life and well-being and health; • Policies should address early life development, working age, and ageing; • Action on the determinants of health should involve the whole of government; • Action on SDH should be founded on evidence.

  3. Health Equity & Core Values • Health equity can be defined as: • “The absence of unfair and avoidable or remediable differences in health among groups defined socially, economically, demographically or geographically“; • Both within countries and between countries • Governments are accountable; • Tackling health inequities requires action on SDH.

  4. Commission Activities

  5. A Structure of Work Streams • Commissioners • Knowledge Networks • Country Work • Civil Society Work • Global Initiatives • WHO Reference Group

  6. Commissioner Meetings • Chile – March 2005 • Egypt – May 2005 • India – September 2005 • Iran – Jan 2006 • Kenya – June 2006 • Brazil – Sept 2006

  7. CSDH Knowledge – the Causes of the Causes SOCIAL CONTEXT CULTURE, RELIGION, SOCIAL SYSTEM, HUMAN RIGHTS, LABOUR MARKET, EDUCATION SYSTEM STRUCTURAL DETERMINANTS INCOME, EDUCATION, GENDER, ETHNICITY, AGEING GLOBALIZATION HEALTH SYSTEMS INTERMEDIARY DETERMINANTS LIVING AND WORKING CONDITIONS, HEALTH-RELATED BEHAVIOURS BIOLOGICAL PROCESSES HEALTH

  8. Integrating Knowledge for Action

  9. Env. Change Education Aid Migration Globalisation ECD Ageing Gender Rural Settings Social Excl PPHC Mental Health Urban Settings Food Working Conditions Health Systems Evidence/Measurement Medical Education Violence Alcohol Psychosocial Commission’s SDH Thematic Areas Sonia was born to a poor family in a remote rural village. With no formal schooling, her mother works as casual labour. Her father is unemployed, after losing his small-holding to creditors. She attends a local primary school, when she is not looking after her younger brothers, and when she is not sick. She has had bouts of illness from birth, but has given up going to the health centre where she is looked down on and treated badly, and rarely has the money to pay the fees.

  10. Putting Knowledge to Work • The Globalisation KN looks both at ways in which globalisation can improve social and economic conditions, and at how it needs to be fair; • The Employment Conditions KN looks at how processes of global economic integration and power relations at the local level interact to affect conditions of labour; • The Urban Settings KN looks at the natural, physical, social and economic capital of the urban environment; • Urbanisation is understood in the context of rural issues such as patterns of land-holding, and food access and availability.

  11. Putting Knowledge to Work • The Gender KN focuses on disparities between the sexes in opportunities for participation along the life course; • The Health Systems KN focuses on cross-government stewardship for health, in which the health care system plays a central role; • The Early Child Development KN is working to strengthen approaches to physical, emotional and cognitive development from the beginning; • The Social Exclusion KN emphasises the impact across society of selective marginalisation of groups.

  12. CSDH Country Work

  13. EURO • Sweden (Formal Partner) • England (Formal Partner) • Kyrgyzstan(Formal Partner) • Norway (Exploring) AFRO • Kenya(Formal Partner) • Senegal (Exploring) • Mozambique (Sending Letter - Exploring) • Malawi (Exploring) • Tanzania (Exploring) • Zambia (Exploring) WPRO • Mongolia (Exploring) • New Zealand (Exploring) AMRO / PAHO • Chile (Formal Partner) • Brasil (Formal Partner) • Canada (Formal Partner) • Bolivia (Formal Partner) • Peru (Formal Partner) • Nicaragua (Exploring) EMRO • Iran (Formal Partner) • Exploring with regional office SEARO • India (Exploring) • Sri-Lanka (Formal Partner)

  14. Country Knowledge into Action • Developing a national SDH equity plan of action, and participatory process; • Whole of government, cross-sectoral action to address the disadvantages Sonia experiences; • Baseline situation analysis and implementation/ evaluation of specific policies/programmes; • Recognising, identifying and acting on community needs.

  15. Setting up national health equity information systems; • Ensuring sustainable and timely information to underpin government strategy • Making the economic case for investing upstream in health; • Increasinginvestment in the causes of the causes • Building evidence and knowledge of good practice; • Strengthening the community of knowledge • Capacity building

  16. Civil Society

  17. Civil Society Work • Plurality of perspectives, and direct representation • Understanding how civil society can effect policy • Partnership strengthening the sustainability of the SDH movement

  18. Update Regional and Regional activities Regional Meeting National Meeting Country Participants

  19. Global Initiatives

  20. Env. Change Education Aid IFIs Regional Orgs. Donors Global Fora UN Migration Globalisation ECD Ageing Gender Rural Settings Social Excl PPHC Mental Health Urban Settings Food Working Conditions Health Systems Evidence/Measurement Medical Education Violence Alcohol Psychosocial Global Targets

  21. Global Initiatives • Engage global institutions • To foster globalisation that protects equity; • To take into account equity in health in their policies, and support national policy space for health; • To increase investments towards action on social determinants of health . • Engaging with multiple stakeholders, including G8, the World Bank, ECOSOC, the UN; • Aiming regionally (in LAC) to engage with ECLAC, OAS, IADB and others.

  22. CSDH: Reporting and Action

  23. 2008: A Global Launch • A historical opportunity? 1948-1978-2008; • A global media launch – CNN; • A global movement – a critical mass of world leadership; • Engaging all levels – heads of state, country governments, regional champions – to build and institutionalise sustainable commitment to the SDH agenda.

  24. Joint meeting of global Commission on Social Determinants of Health and Brazilian National Commission on Social Determinants An opportunity to explore collaboration around: • Knowledge, advocacy and action; • At national, regional and global level • Nordic, Asian and Latin American

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