Addressing Determinants of Health for Advancing Equity

There is a difference of 18 years of average life expectancy between high- and low- income countries. Relative inequalities within countries and between poorer and richer subgroups regarding disease like cancer have for example increased in recent years. Health inequities have a significant financial cost: across the EU, estimates of losses are around 1.4% of gross domestic product, a situation exacerbated in low income countries. Opportunities to be healthy are closely linked to the conditions shaping how people grow up, learn, live, work and age. Inequalities in these conditions lead to certain groups having poorer quality housing and education, fewer employment opportunities, and less access to safe environments, clean water and air, food security and health care. These social, environmental and economic circumstances, in turn, negatively impact health and lead to health inequities. The COVID-19 pandemic has exposed and magnified existing social, economic, gender, ethnic, and health inequities.

Building on the pioneering normative work carried out by WHO and the experience and leadership of the Institute of Health Equity (UK) and UNISANTE Lausanne in addressing social determinants of health, a global initiative aiming to ensure that health equity is integrated into the development of social and economic policies for at least 20 million disadvantaged people, has been developed. The three key strategies of the program are: 1) improving impact assessment and surveillance of trends in social determinants affecting health equity, and harnessing evidence for context-relevant, normative and practical guidance and tools; 2) supporting participatory learning and empowerment of communities in multisectoral collaborations addressing social determinants of health; 3) improving and sustaining social and economic policies and coordinated social and health services that build-back better from COVID-19.

Lessons on SDC’s community-based approaches, multisectoral coordination and experience in policy dialogue on determinants of health and equity, is a foundation for strong collaboration, global advocacy and further scale-up of successful work in countries. The additional credit approved by the Federal Council to support WHO’s work in Latin America will be used for supporting Chile, El Salvador, Peru and Colombia.

Policy-makers leading multisectoral social and economic response strategies for COVID-19, at local, national, global level.

People living in vulnerable circumstances, including those with deteriorated circumstances from COVID-19.

Community leaders, health and development administrators from local government and civil society organizations advocating for and supporting domestic workers, construction workers, street vendors and migrants.

Staff at primary health care and social care.

Academia involved in training on social determinants of health.

1.   Public health evidence, data and guidance on social determinants of health translated into practical tools and information products that give salience to health equity and social determinants as performance metrics of the health system and other sectors.

2.   Improved training resources for health professionals and strengthened WHO and UN staff capacities in addressing social determinants of health and equity, linked to a gender-equity and human rights approach.

3.   National policies and community development programs, including those for COVID-19 recovery, build on social determinants of health equity assessments, identify concrete multisectoral actions and address barriers to health service access.

4.   Health leaders share a common understanding and narrative on social determinants of health and equity that is disseminated locally, regionally and globally.

Principaux résultats attendus:  

·  First World Report on the Social Determinants
of Health Equity and World database and
community tool on social determinants of
health released.

·  Training “Migration and Health Equity”
at WHO Academy carried out; WHO Manual
for summer schools on social determinants
of health developed.

·  Scale-up WHO/UN equity and gender
mainstreaming

·  Networks and communities of practice
for social determinants of health knowledge
sharing at regional and country levels, set up
and functional.

·  Regional assessments, data, literature reviews
on social determinants of health, finalized.

-  Support to civil society organizations assisting
domestic workers, construction workers, street
vendor organizations and associations of migrants,
in selected Latin American countries.

Principaux résultats antérieurs:  

The opening phase achieved to:
·  Assess key global social determinants of health challenges linked to COVID-19, hold a related WHO staff webinar, embed COVID-19 in the program;

·  Progress the first WHO World Report on the Social Determinants of Health Equity;

·  Develop and test a virtual teaching module on multisectoral approaches for addressing social determinants of health with the University of Lausanne;

·  Compile rapid regional assessments of COVID-19 and social determinants of health in 3 regions and develop 7 country profiles;

·  Select 9 countries/territories (Chile, Colombia, Costa Rica, El Salvador, Peru, Morocco, Occupied Palestinian Territory, Cambodia, Mongolia) for targeted action and initiate plans with Ministries of Health;

-  Increase advocacy on social determinants of health: health equity slide show, plan for the WHO Film Festival, COVID-19 webinar; launch of the Sustainable Health Equity Movement.