Social Work and the Social Determinants of Health Perspective: A Good Fit

Abstract

The social determinants of health perspective--rooted in the work of Leonard Syme, Geoffrey Rose, Michael Marmot, Richard Wilkinson, and others (Marmot, 2005; Wilkinson & Marmot, 2003)--provides evidence that our social environment plays a key role in determining health status. Certain groups, due largely to their socioeconomic status, are at greater risk for poor health outcomes; even more disturbing, researchers have found that social inequality within a population, regardless of a nation's level of material wealth or quality of health care, leads to poor health outcomes (Wilkinson & Pickett, 2006). Examining a broad range of social factors-material conditions, psychosocial variables, social cohesion, childhood development (Smith & Egger, 1996)--enables us to understand the impact of such factors on health, factors that seem as or even more important than traditional medical factors such as access, quality of care, and technological advancements in medicine. This perspective fits well with social work's biopsychosocial approach to understanding and ameliorating complex social problems and its commitment to social justice. SOCIAL DETERMINANTS OF HEALTH PERSPECTIVE The literature on the social determinants of health shows that health is essentially a biopsychosocial phenomenon. As researchers, primarily from England and Canada, looked more closely at the health of populations, they discovered that countries with the greatest wealth, as measured by per capita gross national product and median income, do not necessarily have the healthiest populations (Wilkinson, 1996). Although the United States is the wealthiest nation in the world and spends more per capita on health care than any other country, it has poorer health than 20 developed countries, including all European Union (EU) nations (Wilkinson, 2001, p. 30; Pickett W 2) Tackle the inequitable distribution of power, money, and resources-the structural drivers of those conditions of daily life--globally, nationally, and locally; and 3) Measure the problem, evaluate action, expand the knowledge base, develop a workforce that is trained in the social determinants of health, and raise public awareness about the social determinants of (WHO, 2008, p. 6) EFFORTS TO INCORPORATE THE SOCIAL DETERMINANTS OF HEALTH PERSPECTIVE INTO SOCIAL POLICY Scholars from the United Kingdom and Canada have played a leading role in efforts to achieve health equity through action on the social determinants of health. Michael Marmot, at the request of the British Secretary of State for Health and the Commission on Social Determinants, prepared a set of recommendations to help England reduce health inequalities post-2010 and include a social determinants of health perspective in its policies and interventions. …