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AJPH First Look, published online ahead of print Sep 17, 2009
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November 2009, Vol 99, No. 11 | American Journal of Public Health 1967-1974
© 2009 American Public Health Association
DOI: 10.2105/AJPH.2008.154856

FRAMING HEALTH MATTERS

Changes Not for the Fainthearted: Reorienting Health Care Systems Toward Health Equity Through Action on the Social Determinants of Health

Fran E. Baum, PhD, Monique Bégin, Tanja A. J. Houweling, PhD and Sebastian Taylor, PhD

Fran E. Baum is with the Faculty of Health Sciences, Flinders University, Adelaide, Australia. Monique Bégin is with the Telfer School of Management, University of Ottawa, Ontario, Canada. Tanja A. J. Houweling and Sebastian Taylor are with the Department of Epidemiology and Public Health, University College London, England.

Correspondence: Correspondence should be sent to Fran E. Baum, PhD, Southgate Institute for Health, Society and Equity, Health Sciences Building Room 2.05, Faculty of Health Sciences, Flinders University, GPO Box 2100, Adelaide 5001, Australia (e-mail: fran.baum{at}flinders.edu.au). Reprints can be ordered at http://www.ajph.org by clicking the "Reprints/Eprints" link.

Entrenched poor health and health inequity are important public health problems. Conventionally, solutions to such problems originate from the health care sector, a conception reinforced by the dominant biomedical imagination of health. By contrast, attention to the social determinants of health has recently been given new force in the fight against health inequity. The health care sector is a vital determinant of health in itself and a key resource in improving health in an equitable manner. Actors in the health care sector must recognize and reverse the sector's propensity to generate health inequity. The sector must also strengthen its role in working with other sectors of government to act collectively on the deep-rooted causes of poor and inequitable health.




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