Dear colleagues,

I completely agree with Jennie’s sentiments. My worry is that this 
figure will start being referenced and the figures allocated to 
“different social determinants of health” will become reified. Can we 
ask Wikipedia to edit (delete) this figure on the basis that the 
methodology underpinning is dodgy?
Apparently it is derived from referenced sources (including an NEJM 
paper from 2007! I am not sure NEJM is the best source of SDH evidence, 
let alone a paper from 2007) and face to face interviews with public 
policy analysts, health IT experts, and clinical professionals (what 
about the social scientists?)
https://www.goinvo.com/features/determinants-of-health/#methodology

All the best,
Tarani


From: Social Determinants of Health [mailto:[log in to unmask]] On Behalf Of 
Popay, Jennie
Sent: 18 September 2018 18:16
To: [log in to unmask]
Subject: Re: [SDOH] Canadian alternative in a similar format??

I don’t usually comment on this network but this type of diagrammatic 
representation of what we know to be very complex interrelated pathways 
to health and particularly to health inequalities drives me bananas.  It 
is one of the worst example of the quantification of ‘risk’ pathways I 
have seen -and I have seen quite a few over my career. Representations 
like this are deceptively ‘simple’ – and because of that simplicity (for 
which read simplistic)  too many people love them and hence they further 
reinforce the lifestyle drift tendency of so much professional health 
‘work’.  Where to start with the problems – well maybe with the fact 
that we know from much research that many health related behaviours are 
shaped by, and deeply embedded in, socio-economic conditions in which 
people live and work and over which many of those with the worse health 
have little if any control.  So  how can the contribution of these two 
key aspects of the life scape to an individual’s health be given 
separate weights in any kind of meaningful way.   I find this kind of 
graphic so very depressing. 
Jennie 

Jennie Popay
Professor of Sociology & Public Health
Director of Engagement NIHR CLAHRC NW Coast http://www.clahrc-
nwc.nihr.ac.uk/index.php
Division of Health Research
Faculty of Health & Medicine
Lancaster University
Furness Building
Bailrigg
Lancaster LA1 4YG
Tel: 01524 593377

From: Social Determinants of Health <[log in to unmask]> on behalf of Lara 
Mylly <[log in to unmask]>
Reply-To: Social Determinants of Health <[log in to unmask]>
Date: Tuesday, 18 September 2018 at 14:33
To: "[log in to unmask]" <[log in to unmask]>
Subject: [SDOH] Canadian alternative in a similar format??

Hello all:
One of the M.D.’s on our team sent me this graphic and link. 
 
The format and content resonated with her and she is interested in 
working with me to facilitate an event targeting our other medical staff 
team members to engage them in identifying one project or theme that our 
team might work on. 
 
She would like to use this diagram to review with the team and I wonder 
about the origin and accuracy of this, as well as the volume of info. In 
this specific resource. 
 
Are there any suggestions for an alternative resource that is Canadian 
and is represented in graphic form, as this is a format she would like 
to use?
 
Thoughts and suggestions?
 
Source: 
https://commons.wikimedia.org/wiki/File:Social_Determinants_of_Health_In
foviz.jpg
 
 
 
 

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