This workbook is for community-based organizations seeking to affect the social determinants of health through community-based participatory approaches and nontraditional partnerships. Along with an introduction to the concepts of health equity, the workbook presents case studies of communities working at both small and large scales. The authors then provide guidelines for developing your own initiative, from creating partnerships to identifying your approach to assessing and maintaining your progress.

This issue of cdnr is the first part of a 2-part series on eliminating health disparities. It includes articles on disparities in maternal and child health, eliminating disparities in oral health, and health disparities among Native Hawaiians and other Pacific Islanders.

This issue brief provides evidence and explanations for striking differences health status by both race and socioeconomic status.

The authors review evidence that suggests that segregation is a primary cause of racial differences in socioeconomic status (SES) by determining access to education and employment opportunities. SES in turn remains a fundamental cause of racial differences in health. Segregation also creates conditions inimical to health in the social and physical environment. The authors conclude that effective efforts to eliminate racial disparities in health must seriously confront segregation and its pervasive consequences

In profiling researcher Arline Geronimus and the development of her weathering hypothesis, this article lays out evidence for the relevance of racism and other social factors for understanding population health, particularly in the example of teen pregnancies in low-income Black communities. Could serve as an introduction to the topic for those new to health equity ideas.

This memo offers recommendations for targeting Prevention and Wellness recovery funds to maximize the health and equity benefits in the Recovery Act of spring 2009. It makes the case that prioritizing disease prevention – particularly among the most impacted communities – is imperative to strengthening the nation. It makes specific recommendations for using funds to
- Build upon and leverage existing prevention initiatives;
- Promote equity by targeting America’s low-income communities and communities of color;
- Target multi-disciplinary strategies focused on environmental change;
- Develop the health workforce to effectively shape and implement prevention efforts; and
- Advance a vision of healthy people, healthy places.

This report encapsulates the critical thinking, key arguments and recommendations of nationally  recognized experts in the area of social determinants of health equity.  A principle thesis of the Expert Panel is that the inequitable distribution of resources needed for health is the major contributor to persistent health inequities.  These experts called to account conditions and processes, including class disadvantage and racism, that prevent many Americans from enjoying the health and long life that affluent and privileged citizens take for granted.  Many of the strategies for addressing social determinants of health equity fall outside current public health practice but not outside the profession’s historic role in public policy decisions that promote social justice.

Health inequalities between rich and poor people are much lower in areas that have lots of green space, such as parks, forests and playing fields, a large British study finds.

How healthy are people who are working but still can’t make ends meet? How does their health compare to those who are working and have good incomes? How do both of those health outcomes compare to those who are poor and not working? This report shows a widening gap between the health of people who are living in poverty and working and those whose work provides sufficient incomes. This suggests that worsening labour market conditions, a weakened social safety net and increasing income inequality are accompanied by rising inequities in health.

Journalist Jill Eisen explores the importance of the social determinants of health from a Canadian perspective. The program devotes considers the importance of looking at "upstream" causes of health and presents possible policies for intervention on different levels.
Part One: S. Leonard Syme, Richard Glazier, Carol Shively, and Michael Marmot explain the concepts behind social determinants of health, present evidence for how stress contribute to "modern" diseases, and elaborate the moral and practical obligations we have to demand action. Part Two: Dennis Raphael, Richard Glazier, and Clyde Hertzman discuss the obesity and diabetes epidemics and early childhood development. Raphael makes an interesting commentary as to why governments continuously fail to address social threats to health.

In this audio podcast, excerpted from an interview conducted during the making of UNNATURAL CAUSES, Sir Michael Marmot of University College, London, discusses the social gradient in health, his pioneering Whitehall Studies and why he's optimistic about improving health outcomes.

ENHANCED PODCAST (m4a)

In an original interview, Michael Marmot discusses how he got into public health issues, then addresses a wide range of issues, from the healthy immigrant effect to social gradients in smoking to why the wealthy should care about health inequities... and what we can do about them.

This thorough text examines the history of public health in Sweden, with particular attention to the emergence of the welfare state in the past century. Say the authors, "Historical lessons cannot be transferred uncritically from one country to another. However, differences and similarities in appropriate contexts can increase our understanding of relations between health and society. We hope that this book will be useful for policy comparisons and in the training of public health policy-makers, researchers, administrators and practitioners."

Full pdf available online, 5 MB.

This Knowledge Network (KN) examines the relational processes that lead to the exclusion of particular groups of people from engaging fully in community/social life. These processes may operate at: the macro-level (access to affordable education, equal employment opportunity legislation, cultural and gender norms), and/or the micro-levels (income, occupational status, social networks - around race, gender, religion). The network also examines the linkages between social exclusion and proximal concepts such as social capital, networks and integration.

Socioeconomic status (SES) underlies three major determinants of health: health care, environmental exposure, and health behavior. In addition, chronic stress associated with lower SES may also increase morbidity and mortality. Reducing SES disparities in health will require policy initiatives addressing the components of socioeconomic status (income, education, and occupation) as well as the pathways by which these affect health. Lessons for U.S. policy approaches are taken from the Acheson Commission in England, which was charged with reducing health disparities in that country.

In addition to the traditional approaches of health sciences and the sociology of health, this contributed volume shows the impact that human rights issues and political economy have on health, and takes up these issues as they occur in Canada and the United States within a wider international context. The book also contains chapters on issues of pharmaceutical policy, social exclusion, gender and care, the social construction of illness and disability, and approaches to promoting population health that include insights into the impact of economic forces such as globalization and privatization on health care and other health issues.

SAJE is an economic justice, community development, and popular education center that has been building economic power for working class people in Los Angeles since 1996. Over the past eleven years, SAJE's winning combination of community organizing, coalition-building, and grassroots policy has gained significant benefits for the community. Accomplishments include creating the nation's first welfare-to-work bank account and, through the Figueroa Corridor Coalition for Economic Justice, negotiating the nation's most comprehensive community benefits agreement.

The Strategic Alliance is a coalition of nutrition and physical activity advocates in California, working to shift the debate on nutrition and physical activity away from a primary focus on personal responsibility and individual choice to one that examines corporate and government practices and the role of the environment in shaping eating and activity behaviors. The Alliance's goal is to benefit the health and wellness of all California residents by promoting environmental solutions and institutional and government policies and practices that support healthy eating and activity.

Professor Sir Michael Marmot has been asked by the British government to Chair an independent Review to propose the most effective strategies for reducing health inequalities in England from 2010. This review is a response to the recommendation of the WHO Commission on Social Determinants of Health that national governments develop and implement strategies and policies suited to their particular national context aimed at improving health equity.

A supplement to the latest issue of the American Journal of Preventive Medicine (AJPM), funded by the Robert Wood Johnson Foundation, includes six articles and a broad array of commentaries that provide a fundamental understanding of the fact that where, we live, learn, work and play has as much to do with our health as the health care we receive.

The authors–including Risa Lavizzo-Mourey, David R. Williams, Michael G. Marmot and more–address factors beginning with early childhood education, to homes and communities, to the economic rationale for improving the lives of disadvantaged Americans. Together, the collection provides an in-depth look at why some Americans are so much healthier than others and why Americans are not the healthiest people in the world.

Social justice has always been a core value driving public health. Today, much of the etiology of avoidable disease is rooted in inequitable social conditions brought on by disparities in wealth and power and reproduced through ongoing forms of oppression, exploitation, and marginalization.

Tackling Health Inequities raises questions and provides a starting point for health practitioners ready to reorient public health practice to address the fundamental causes of health inequities. This reorientation involves restructuring the organization, culture and daily work of public health. Tackling Health Inequities is meant to inspire readers to imagine or envision public health practice and their role in ways that question contemporary thinking and assumptions, as emerging trends, social conditions, and policies generate increasing inequities in health.

How does socioeconomic status get under the skin? This book summarizes the decade of research by the MacArthur Foundation Research Network on Socioeconomic Status and Health “exploring the pathways and mechanisms that contribute to the gradient relationship between socioeconomic status and health.”

PDFs of each article are available online.  You may also purchase a complete copy of the journal.

Between 1966 and 1980, socioeconomic inequities in premature mortality and infant death shrank, absolutely and relatively, especially for US populations of color. However, starting in 1980, the relative gaps widened and the absolute gaps remained unchanged.

In this short piece, journalist Drexler makes a case for the incoming president to make a serious commitment to improving national health by looking beyond health care to policies that shape employment, housing, transportation, agriculture, taxation, and other social issues.