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Volume 101, Issue 4 (April 2011)
James R. Hargreaves, Delia Boccia, Carlton A. Evans, Michelle Adato, Mark Petticrew, and John D. H. Porter The Social Determinants of Tuberculosis: From Evidence to Action. American Journal of Public Health: April 2011, Vol. 101, No. 4, pp. 654-662.
doi: 10.2105/AJPH.2010.199505

Accepted on: Jul 10, 2010

The Social Determinants of Tuberculosis: From Evidence to Action

James R. Hargreaves, PhD, MSc, Delia Boccia, PhD, Carlton A. Evans, MD, PhD, DTM&H, Michelle Adato, PhD, Mark Petticrew, PhD, and John D. H. Porter, MD, MPH
Correspondence should be sent to James Hargreaves, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK (e-mail: ). Reprints can be ordered at http://www.ajph.org by clicking the “Reprints/Eprints” link.

Peer Reviewed

Contributors

J. R. Hargreaves and D. Boccia conceptualized the article. J. R. Hargreaves led the writing and contributed to all aspects of the article. D. Boccia led work on urban regeneration. C. A. Evans provided information about tuberculosis control and the project in Peru. M. Adato led on aspects of social protection. M. Petticrew contributed expertise on urban regeneration and evaluation of structural interventions. J. D. H. Porter contributed expertise on tuberculosis control and structural interventions. All authors participated in writing the article and agreed to the final draft.



ABSTRACT

Growing consensus indicates that progress in tuberculosis control in the low- and middle-income world will require not only investment in strengthening tuberculosis control programs, diagnostics, and treatment but also action on the social determinants of tuberculosis. However, practical ideas for action are scarcer than is notional support for this idea. We developed a framework based on the recent World Health Organization Commission on Social Determinants of Health and on current understanding of the social determinants of tuberculosis. Interventions from outside the health sector—specifically, in social protection and urban planning—have the potential to strengthen tuberculosis control.