Health Equity and the Societal Determinants of Health

Abstract

Abstract Operationalizing our political economy of health framework, this chapter introduces the role of societal determinants and determination of health (SDOH) in producing health and disease at multiple, co-existing levels: historical, social, economic, and political contexts (including colonialism, the trade and production regime, distribution of wealth, and class, race, and gender-based power and social structures); societal governance and social policies (including democratic processes, welfare state regimes, and conditions related to migration, poverty, education, work, environment, and public health); living conditions (including neighborhood and housing conditions, nutrition, water and sanitation, and transport). Drawing from ecosocial theory, the chapter examines how these synchronous levels and the intersectionality of SDOH over the lifecourse lead to population patterns of health inequities and embodiment of health and illness in individuals. We conclude the chapter with an overview of approaches to addressing SDOH to achieve health equity, turning to global, national, and municipal intersectoral approaches.