Recommendations by the CSDH

These recommendations are at the heart of the work carried out  by the CSDH, the Executive Summary of which can be downloaded in the six official languages of the WHO —English, Spanish, Russian, French, Arabic and Chinese— from:
http://www.who.int/social_determinants/final_report/en/
The full report in English [256p.] is available in PDF format at:
http://www.who.int/entity/social_determinants/final_report/csdh_finalreport_2008.pdf

Please find below a summary of these recommendations. We would like to encourage you as participants of the Introductory Module to delve into the recently published reports.

This work resulted from the systematic and expert analysis of the information on the SDH and their impact on the population’s health offered by the Knowledge Networks created to this end.

The Commission on Social Determinants has recommended some priorities to guide public policies, programs and concrete actions aimed at attaining the following:

1. Equity from the start

This involves committing to and implementing a more comprehensive approach to early life, building on existing child survival programs and extending interventions in early life to include social/emotional and language/cognitive development

Set up an interagency mechanism to ensure policy coherence for early child development such that a comprehensive approach to early child development is acted on.

Make sure that all children, mothers, and other caregivers are covered by a comprehensive package of quality early child development programs and services, regardless of ability to pay.

Provide quality primary and secondary education for all boys and girls, regardless of ability to pay and identify and address the barriers to girls and boys enrolling and staying in school

2. Healthy places - Healthy people

Place health and health equity at the heart of urban governance and planning..

Promote health equity between rural and urban areas through sustained investment in rural development, addressing the exclusionary policies and processes that lead to rural poverty, landlessness, and displacement of people from their homes.

Ensure that economic and social policy responses to climate change and other environmental degradation take into account health equity.

3. Fair employment and decent work

Make full and fair employment and decent work a central goal of national and international social and economic policy-making.

Achieving health equity requires safe, secure, and  fairly paid work, year-round work opportunities, and healthy work-life balance for all.

Improve the working conditions for all workers to reduce their exposure to material hazards, work related stress, and health-damaging behaviors.

4. Social protection across the life course

Establish and strengthen universal comprehensive social protection policies that support a level of income sufficient for healthy living for all.

Ensure that social protection systems include those normally excluded: those in precarious work, including informal work and household or care work

5. Universal health care

Build health-care systems based on principles of equity, disease prevention, and health promotion.

Build and strengthen the health workforce, and expand capabilities to act on the social determinants of health

6. Health equity in all policies, systems and programs

Place responsibility for action on health and health equity at the highest level of government, and ensure its coherent consideration across all policies.

Adopt a social determinants framework across the policy and programmatic functions of the ministry of health and strengthen its stewardship role in supporting a social determinants approach across government

7. Fair financing

Strengthen public finance for action on the social determinants of health.

Increase international finance for health equity, and coordinate increased finance through a social-determinants-of-health action framework.

Fairly allocate government resources for action on the social determinants of health

8. Market responsability

Institutionalize consideration of health and health equity impact in national and international economic agreements and policy-making.

Reinforce the primary role of the state in the provision of basic services essential to health (such as water/sanitation) and the regulation of goods and services with a major impact on health (such as tobacco, alcohol, and food)

9. Gender equity

Address gender biases in the structures of society —in laws and their enforcement, in the way organizations are run and interventions designed, and the way in which a country’s economic performance is measured.

Develop and finance policies and programs that close gaps in education and skills, and that support female economic participation.

Increase investment in sexual and reproductive health services and programs, building to universal coverage and rights

10. Political empowerment - Inclusion and voice

Empower all groups in society through fair representation in decision-making about how society operates, particularly in relation to its effect on health equity, and create and maintain a socially inclusive framework for policy-making.

Enable civil society to organize and act in a manner that promotes and realizes the political and social rights affecting health equity.

11. Good global gobernance

Make health equity a global development goal, and adopt a social-determinants-of-health framework to strengthen multilateral action on development.

Strengthen WHO leadership in global action on the social determinants of health, institutionalizing social determinants of health as a guiding principle across WHO departments and country programs.

12. Measure and Understand the Problem and Assess the Impact of Action

Ensure that routine monitoring systems for health equity and the social determinants of health are in place, locally, nationally, and internationally.

Provide training on the social determinants of health to policy actors, stakeholders, and practitioners and invest in raising public awareness.

Invest in generating and sharing new evidence on the ways in which social determinants influence population health and health equity and on the effectiveness of measures to reduce health inequities through action on social determinants

Closing the gap in a generation: Health equity through action on thesocial determinants of health | pdf