Commission Sheds Light on Social Barriers to Health

Health officials, academics, and members of civil society organizations from throughout the Americas joined experts from the Pan American Health Organization/World Health Organization (PAHO/WHO) to discuss how to overcome social barriers to health at a regional consultation on the work of the global Commission on Social Determinants of Health, held at PAHO headquarters July 5–6.

The Commission on Social Determinants of Health was launched earlier this year, at the urging of WHO Director-General LEE Jongwook, to recommend and promote policies and practices that improve health and narrow health inequalities by addressing social factors.This was the second in a series of regional consultations on the commission's work and the first in the Americas.

Health policies cannot ignore social factors, says a new commission established by WHO. © Armando Waak/PAHO

Participants in the PAHO meeting noted that in the Americas and throughout the world, vulnerable and socially disadvantaged people have less access to health resources, get sicker, and die earlier than those in more privileged social positions. These gaps are growing despite unprecedented global wealth, knowledge, and health awareness.

Health policies have traditionally focused on diseases and medical solutions, largely ignoring the effects of the social environment on health. As a result, health problems persist, inequalities have widened, and health interventions fall short of optimal results.

"What good does it do to treat people's illnesses . . . then send them back to the conditions that made them sick," said Timothy Evans, WHO assistant director general for evidence and information for policy.

The new commission cites a growing body of evidence showing how interventions that address the social dimensions of health can improve health conditions and access to health care. These include:

• Prevention and health promotion campaigns targeting vulnerable groups.
• Occupational health services for all employees.
• Job rotation for laborers in high-risk jobs.
• Employment protection for chronically ill citizens.
• School-based health and nutrition services.
• Healthy food catering to workplaces.
• Social welfare programs that make benefits conditional on children's school attendance, regular medical checkups, and other health-promoting actions.

Participants in the meeting discussed ways to support the commission's work by gathering and sharing evidence and best practices on successful interventions; developing and implementing policies that address key social determinants; raising awareness in government, civil society, and the health sector about the need to address social determinants; and incorporating social determinants of health interventions and related approaches into planning, policy, and technical work within PAHO/WHO.

Participants in the PAHO meeting included commissioners Monique Begin of Canada and David Satcher of the United States; Elisabeth Duarte of Brazil's Ministry of Health; Sylvie Stachenko of the Public Health Agency of Canada; Andrés Botrán, secretary of food and nutritional security of Guatemala; Damian Greaves, minister of health of St. Lucia; Penelope Royall, deputy assistant secretary for health of the U.S. Department of Health and Human Services; and Sir George Alleyne, former director of PAHO and currently president of the Caribbean Commission for Health and Development.

More information on the work of the global commission is available at www.who.int/social_determinants.