Missed Opportunities: The Human Rights Gap in the Report of the Commission on Social Determinants of Health

Abstract

In August 2008, the Commission on Social Determinants of Health (CSDH) of the World Health Organization published its report, Closing the Gap in a Generation: Health Equity Through Action on the Social Determinants of Health. The report integrates extensive data from a wide variety of sources on the significant role of the social determinants of health in shaping health outcomes and generating inequalities in health status within and among countries. This analysis is juxtaposed with a compelling justice ethic. The report addresses many of the same issues and expresses many of the same concerns as the health and human rights community and more broadly human right scholarship and advocacy on other economic and social rights. Nevertheless, the CSDH did not acknowledge this common ground. Nor did the report explicitly place access to the key social determinants of health in a human right framework. This article addresses the implications of the CSDH's unwillingness to acknowledge its shared ground with and to adopt at least some elements of the human rights paradigm for its report. It discusses areas of overlap and difference between a human rights paradigm and the social determinants and equity framework adopted by the CSDH. It argues that the failure to incorporate an explicit human rights approach weakened the line of reasoning in some sections of Closing the Gap in a Generation, rseduced prospects for adoption of its recommendation and diminished the likelihood of fulfilling its mandate to foster a global movement to promote health equity.