Community interventions on social determinants of health focusing the evidence

Abstract

Public health has been described as "what we as a society do to collectively assure the conditions in which people can be healthy" (IOM 1989, 2003). The Ottawa Charter for Health Promotion identifies eight essential preconditions to health (Ottawa Charter for Health Promotion, 1986). Over the past decade-and-a-half, the term "social determinants of health" has been used broadly to refer to social and economic factors that influence health, including income, food, housing, education, safety, social relationships, and health care. Social determinants have also been described as " . . . life-enhancing resources and opportunities that effectively determine the length and quality of life by their distribution across populations" (James, 2002), pointing to the need to consider not only what the conditions are, but also for whom. Joining conditions needed for health to questions of distribution locates the realm of social determinants within the health promotion arena, where equity has always been emphasized, at least conceptually, if not always in practice.