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Mirkuzie Woldie , Ethiop Med J, 2022, Vol. 60, No. 1
EDITORIAL
ADDRESSING THE ROOT CAUSES: SOCIAL DETERMINANTS OF HEALTH AND
DISEASE
Mirkuzie Woldie 1M.D., M.P.H
The definition of health has heavily been contested in the literature. The medical view of defining health as the absence of illness has been challenged long time ago. The criticisms mainly relate to the fact that this definition limits determinants of health to the individual level (1). However, health of individuals is shaped by a multitude of factors including social, economic, and political events prevailing in the environment of the individual citizens of a country (1, 2). Health status of individuals in a population cannot be separated from the resources and potential available for them to lead healthy life styles.
The World Health Organization’s (WHO) definition of health has been preferred by global health actors despite the popular reservations about its over ambitious intent. Recent publications by global health scholars have also reaf- firmed the importance of such a broad approach to defining health. McCartney and colleagues suggested a similar approach when they defined health as “a structural, functional and emotional state that is compatible with effective life as an individual and as a member of society (2).”
Use of such a broadly oriented definition of health has several public health and health care related benefits. First- ly, such an approach will
Secondly, such an orientation will make it clear that the development and effective delivery of medical care alone will not do the job of population health development adequately (4). While this is not to mean medical care does not influence population health status, it implies that the concerted effort of other essential sectors outside of the health care system are needed to attain optimal population health development. That is why population health de- velopment should be an integral part of policies crafted and implemented in sectors such as education, housing, and transportation.
Finally, a broad definition of health to address social determinants of health will also influence the design and de- livery of health and medical sciences education in a manner that fits this notion (5). The proper orientation of the health workforce about the role of social determinants of health will enable proper execution of public health inter- ventions by aligning the specific actions at points of health care and upstream actions at the level of policy design.
All of these will
REFERENCES
1.Bircher J, Kuruvilla S. Defining health by addressing individual, social, and environmental determinants: new opportunities for health care and public health. J Public Health Policy.
2.McCartney G, Popham F, McMaster R, Cumbers A. Defining health and health inequalities. Public Health.
3.World Health Organization, Commission on Social Determinants of Health. Geneva: WHO; 2008. Closing the
gap in a generation: health equity through action on the social determinants of health. CSDH final report.
4.Braveman P, Gottlieb L. The social determinants of health: it's time to consider the causes of the causes. Pub- lic Health Rep. 2014;129 Suppl 2(Suppl
5.Williams SD, Hansen K, Smithey M, Burnley J, Koplitz M, Koyama K, et al. Using social determinants of health to link health workforce diversity, care quality and access, and health disparities to achieve health equi- ty in nursing. Public Health Rep. 2014;129 Suppl 2(Suppl 2):32– 6
Senior Research Advisor, Ministry of Health , Addis Ababa, Ethiopia
Email: [email protected]