Palimpsests of 'Social determinants of health'-From historical conceptions to contemporary practice in global and Indian public health

Abstract

Policy attention to the Social Determinants of Health (SDH) has waxed and waned over the years, both in the international and national arena. From famine to plagues, malnutrition to outbreaks, food and hygiene are 'determinants' in that they have motivated the very evolution of public health in India and the globe-albeit stochastically. Moving from colonial to nationalist to neoliberal imperatives, a coherent and abiding vision of social determinants, globally or within India for that matter, has neither endured nor arisen. This vacillation reflects the truly political nature of public health, and also of policymaking on SDH. Following deliberations held in 2013 on an Indian "Health Equity Watch" in which academicians, activists and officials participated, it was acknowledged that for India, there is in fact a substantial literature on SDH that does not explicitly reference the term SDH per se. Thus, this volume seeks to explore two interrelated questions: first, how is action around SDH conceptualized by key stakeholders in our country, and second, what are the themes that bring these conceptualizations together? We have compiled the views of academics and practitioners in both public and private not-for-profit settings to expand upon this issue, supplemented by short commentaries from individuals who reviewed individual chapters and who are involved with the project of health equity in India. From these contributions, we note that there are various vocabularies used to talk about SDH, as well as contestations, various stakeholders, scales and types of activities. Detailing and showcasing this diversity is the contribution of this volume.