From: <b class="gmail_sendername">Ruggiero, Mrs. Ana Lucia (WDC)</b> <span dir="ltr"><<a href="mailto:ruglucia@paho.org" target="_blank">ruglucia@paho.org</a>></span><br><div class="gmail_quote">crossposted from: <a href="mailto:EQUIDAD@listserv.paho.org" target="_blank">EQUIDAD@listserv.paho.org</a><br>
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<p class="MsoNormal" style="margin-left:.5in"><b><font color="maroon" size="2" face="Arial"><span style="font-size:11.0pt;font-family:Arial;color:maroon;font-weight:bold">Action on social determinants of health is essential to
tackle noncommunicable diseases<br>
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<p class="MsoNormal" style="margin-left:.5in"><font size="2" face="Arial"><span style="font-size:10.0pt;font-family:Arial">Kumanan Rasanathan & Rüdiger
Krech <br>
Department of Ethics, Equity, Trade and Human Rights, World Health
Organization, Geneva 1, Switzerland.<u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-left:.5in"><b><font size="2" face="Arial"><span style="font-size:10.0pt;font-family:Arial;font-weight:bold">Bulletin of the
World Health Organization October 2011;89:775-776. doi: 10.2471/BLT.11.094243<br>
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<u></u><u></u></span></font></b></p>
<p class="MsoNormal" style="margin-left:.5in"><font size="2" face="Arial"><span style="font-size:10.0pt;font-family:Arial">Available <font color="black"><span style="color:black">online at: <a href="http://bit.ly/nIxOak" target="_blank"><font color="black"><span style="color:black">http://bit.ly/nIxOak</span></font></a> <u></u><u></u></span></font></span></font></p>
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<p class="MsoNormal" style="margin-left:.5in"><font size="2" face="Arial"><span style="font-size:10.0pt;font-family:Arial">“…..Noncommunicable
diseases cannot be effectively addressed without action on social determinants
of health. Without addressing social inequalities and the conditions in which
people are born, grow, live, work and age, along with the reasons that health
systems work better for some population groups than for others – that is,
adopting a social determinants approach – prospects for reversing the
noncommunicable diseases epidemics are poor.1<u></u><u></u></span></font></p>
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<p class="MsoNormal" style="margin-left:.5in"><font size="2" face="Arial"><span style="font-size:10.0pt;font-family:Arial">This year’s United Nations
General Assembly High-Level Meeting on Prevention and Control of
Noncommunicable Diseases (in <u></u>New York<u></u>) and the
World Conference on Social Determinants of Health (in <u></u><u></u>Rio de Janeiro<u></u><u></u>) provide a unique opportunity
for progress. <u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-left:0.5in"><font size="2" face="Arial"><span style="font-size:10.0pt;font-family:Arial"><br>
There may never be a better global platform for countries, civil society and
international organizations to commit to a coherent social determinants
approach to tackling noncommunicable diseases and other global priorities at
local, national and global levels. In this context, we explain why a social
determinants approach is essential for combating noncommunicable diseases,
discuss what such an approach entails, and identify priority actions for the
global community…”</span></font></p><p class="MsoNormal" style="margin-left:0.5in"><br></p><h1 style="margin-left:.5in"><b><font color="maroon" size="2" face="Arial"><span style="font-size:11.0pt;font-family:Arial;color:maroon">Social determinants of
health: practical solutions to deal with a well-recognized issue<br>
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</span></font></b></h1>
<h1 style="margin-left:.5in"><b><font size="2" face="Arial"><span style="font-size:10.0pt;font-family:Arial;font-weight:normal">Rüdiger Krech - Department of
Ethics, Equity, Trade and Human Rights, World Health Organization, Geneva, Switzerland<br>
</span></font></b><font size="2" face="Arial"><span style="font-size:10.0pt;font-family:Arial">Bulletin of the World Health Organization 2011;89:703-703.
doi: 10.2471/BLT.11.094870<br>
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</span></font></h1>
<h1 style="margin-left:.5in"><b><font size="2" face="Arial"><span style="font-size:10.0pt;font-family:Arial;font-weight:normal">Available online at: <a href="http://bit.ly/mTvy7F" target="_blank"><font color="black"><span style="color:windowtext">http://bit.ly/mTvy7F</span></font></a>
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<p class="MsoNormal" style="margin-left:.5in"><font size="2" face="Arial"><span style="font-size:10.0pt;font-family:Arial">“…..The call on
governments to address the major challenge of health inequities which are
determined by the social conditions in which people are born, grow, live, work,
and age, is not new. The Commission on Social Determinants of Health worked on
this. Its report re-enforces the message from the Ottawa Charter for Health
Promotion, which itself was strongly rooted in the commitments made at the
International Conference on Primary Health Care in Alma-Ata in 1978.1,2</span></font></p>
<p class="MsoNormal" style="margin-left:.5in"><font size="2" face="Arial"><span style="font-size:10.0pt;font-family:Arial"> </span></font></p>
<p class="MsoNormal" style="margin-left:.5in"><font size="2" face="Arial"><span style="font-size:10.0pt;font-family:Arial">The thinking behind the Alma-Ata
Declaration, of course, dates back much further. Public health pioneers, such
as Rudolf Virchow, Robert Koch and Oswaldo Cruz, had an in-depth knowledge of
how social inequities relate to health outcomes.3 Robert Koch, for instance,
devoted a key part of his Nobel Laureate speech in 1905 to the issue.4 And
Brock Chisholm, the first Director-General of the World Health Organization,
asserted in 1949 that “the death rate from pulmonary tuberculosis is now
everywhere accepted as a sensitive index to the social state of a
community.”5 </span></font></p>
<p class="MsoNormal" style="margin-left:.5in"><font size="2" face="Arial"><span style="font-size:10.0pt;font-family:Arial"> </span></font></p>
<font size="2" face="Arial"><span style="font-size: 10pt; font-family: Arial;">Today, we know that this statement
is not only true for tuberculosis but also for noncommunicable diseases,
HIV/AIDS, malaria and other diseases. Reflecting that socio-cultural context is
key to public health, the mandate for the World Health Organization to assist
Member States in addressing the “causes of the causes” of
ill-health is firmly rooted in its constitution.4….”<br><br></span></font><p class="MsoNormal" style="margin-left:.5in"><b><font color="maroon" size="3" face="Arial"><span style="font-size:12.0pt;font-family:Arial;color:maroon;font-weight:bold">Global action on social determinants of health</span></font></b></p>
<p class="MsoNormal" style="margin-left:.5in"><font size="2" face="Arial"><span style="font-size:10.0pt;font-family:Arial"><br>
Michael Marmot </span></font></p>
<p class="MsoNormal" style="margin-left:.5in"><font size="2" face="Arial"><span style="font-size:10.0pt;font-family:Arial">Department of Epidemiology and
Public Health, University College London, London, England.</span></font></p>
<p class="MsoNormal" style="margin-left:.5in"><b><font size="2" face="Arial"><span style="font-size:10.0pt;font-family:Arial;font-weight:bold">Bulletin of the
World Health Organization October 2011;89:702-702. doi: 10.2471/BLT.11.094862<br>
<br>
</span></font></b><font color="black" size="2" face="Arial"><span style="font-size:10.0pt;font-family:Arial;color:black">Available online at: <a href="http://bit.ly/onSHJx" target="_blank"><font color="black"><span style="color:black">http://bit.ly/onSHJx</span></font></a>
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<p class="MsoNormal" style="margin-left:.5in"><font size="2" face="Arial"><span style="font-size:10.0pt;font-family:Arial">“…..Closing the gap in a
generation is a rousing call.1 Did the World Health Organization’s
Commission on Social Determinants of Health (CSDH) really believe it to be
possible? Technically, certainly. Yes, there is a greater than 40-year spread
in life expectancy among countries and dramatic social gradients in health
within countries. But the evidence suggests that we can make great progress
towards closing the health gap by improving, as the CSDH put it, the conditions
in which people are born, grow, live, work and age. </span></font></p>
<p class="MsoNormal" style="margin-left:.5in"><font size="2" face="Arial"><span style="font-size:10.0pt;font-family:Arial"> </span></font></p>
<p class="MsoNormal" style="margin-left:.5in"><font size="2" face="Arial"><span style="font-size:10.0pt;font-family:Arial">These include ensuring: equity for
every child from the start, healthier environments, fair employment and decent
work, social protection across the life course and universal health care. To
make such progress, we must also deal with inequity in power, money and
resources – the social injustice that is killing on a grand scale. At a
more fundamental level, our vision is to create the conditions so that every
person may enjoy the freedoms that lead to improved health – what we call
empowerment.</span></font></p>
<p class="MsoNormal" style="margin-left:.5in"><font size="2" face="Arial"><span style="font-size:10.0pt;font-family:Arial"> </span></font></p>
<font size="2" face="Arial"><span style="font-size:10.0pt;font-family:Arial">In the three years since Closing the
gap in a generation was published, there is no question that there is much to
make us gloomy: the global financial crisis and the steps put in place to deal
with it have worse impacts on the poor and relatively disadvantaged; the
persistence of bad governance nationally and globally; climate change and
inequitable measures for mitigation and adaptation and, in many countries, an
increase in health inequity….”<br><br><br></span></font><font size="2" face="Arial"><span style="font-size:10.0pt;font-family:Arial"><br><br></span></font></div></div></div><br>