Shame that Clyde Hertzman didn't get up.



Professor Graham Vimpani
Clinical Chair
Kaleidoscope in Greater Newcastle
Hunter Children's Health Network
Locked Bag 1
Hunter Region Mail Centre
NSW.  2310
Head of the Discipline of Paediatrics and Child Health
University of Newcastle

Phone +612 4921 3673
Fax +612 4921 3656
mobile 0408 484 427 
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>>> [log in to unmask] 03/18/05 10:50 PM >>>
WHO launches global Commission to tackle the
"causes behind the causes of ill-health"

18 MARCH 2005 | SANTIAGO/GENEVA/LONDON -- Today, the
President of the Republic of Chile, His Excellency Mr
Ricardo Lagos Escobar and World Health Organization
Director-General, Dr LEE Jong-wook launched the Commission
on Social Determinants of Health, a new body to spearhead
action on the social causes behind ill-health.

The new Commission includes leading global experts on
health, education, housing and economics. Commissioners will
work to recommend the best ways to address health's social
determinants and safeguard the health of poor and
marginalized populations, and to break the "poverty equals
ill-health' cycle.

"Social standing plays a big part in whether people will
live to be 40 or 80, whether they will be treated for a
curable disease, and whether their children survive their
fifth birthday. People should not die young because they are
poor. This commission will assist countries, no matter how
rich or poor, to implement strategies that will help people
who are poor and marginalized live longer, healthier lives,"
said Dr Lee at the official launch in Santiago, Chile. "This
effectively places the needs of the disadvantaged first on
the health agenda in the 21st century."

Social determinants are the conditions in which people live
and work. They are the "causes behind the causes" of
ill-health. They include poverty, social exclusion,
inappropriate housing, shortcomings in safeguarding early
childhood development, unsafe employment conditions, and
lack of quality health systems.

The core of the Commission's work will be to identify,
evaluate, adapt and distribute effective strategies to
address social determinants, with the aim of supporting
governments to scale-up interventions. The Commission will
operate for three years from this month.

"A great share of health problems is attributable to social
conditions, and this is why the poor carry the greatest
burden of ill-health. On a global scale, we must ensure that
health policies move beyond exclusively disease-focused
solutions and include the social environment," said
Commission Chair Michael Marmot. "I am honoured to be
working with Commissioners of such a high calibre. We will
arm policymakers with the best evidence to ensure that
poverty does not sentence a person to a shorter, unhealthy
life."

Social determinants are intrinsically linked to inequities
in health. They help to explain why poor and marginalized
people get sick and die sooner than people in better social
positions. They are a significant reason behind the world's
vast difference in average life expectancy, which ranges
from 34 years in Sierra Leone (lowest in the world) to 81.9
in Japan (highest in the world). Social determinants also
account for the majority of health inequities within
countries. In Indonesia, under-five mortality is nearly four
times higher in the poorest fifth of the population than in
the richest fifth. In England and Wales, the latest data
shows a 7.4 year gap in life expectancy between men in
professional occupations and men in unskilled manual
occupations (1997-1999 figures).

Some countries—such as Chile, Sweden, and the United
Kingdom—are already advancing innovative health programmes
that address social determinants through a comprehensive
inter-sectoral approach. For instance, social welfare
programmes with benefits conditional on children's school
attendance, regular medical check-ups, and other
health-promoting actions are helping to reverse the "poverty
equals ill-health" trend. Health inequity assessments
resulting in the declaration of "health action zones" and
health promotion campaigns targeting disadvantaged people
are also safeguarding the health of vulnerable groups.

The Commission will identify successful strategies now
underway in countries. It will work with national
authorities to determine ways to replicate success in other
countries and settings. Whereas, to date, the greatest
progress in tackling social determinants has occurred in
high-income countries, the Commission will focus especially
on identifying and promoting policies applicable in
developing countries, where the adverse health effects of
social determinants are greatest. Overcoming these social
barriers represents a prime opportunity to reduce global
health inequalities and ensure that health gains are
sustainable over time.

The Commission will focus the attention of the world's top
experts and researchers on specific social determinants such
as urban settings, social exclusion, and employment
conditions. These "Knowledge Networks" will push the limits
of current information to better define the links between
social determinants and health, particularly in developing
countries.

The Commission on Social Determinants of Health will work
with national authorities to incorporate social determinants
approaches into efforts to meet the Millennium Development
Goals (MDGs). The MDGs recognize the interdependence of
health and other social conditions, and present an
opportunity to promote health policies that tackle the
social roots of unfair and avoidable human suffering.

The Commission on the Social Determinants of Health


Frances Baum: Australia  Professor of Public Health,
Flinders University, Adelaide; Global Steering Committee,
People's Health Movement

Monique B*gin: Canada  Professor Emeritus, Faculty of Health
Sciences, University of Ottawa; former Canadian Minister of
National Health and Welfare

Giovanni Berlinguer: Italy  Member of European Parliament;
Professor of Hygiene, Occupational Health and of Bioethics
(Emeritus), University "La Sapienza", Rome

Mirai Chatterjee: India  Coordinator of Social Security,
Self-Employed Women's Association (SEWA)

Manuel Dayrit: Philippines  Secretary of Health, Philippines

William Foege: USA  Emeritus Presidential Distinguished
Professor of International Health, Emory University, and
Gates Fellow; former Director of the US Centers for Disease
Control and Prevention

Kiyoshi Kurokawa: Japan  President of the Science Council of
Japan

Ricardo Lagos: Chile  President of the Republic of Chile

Stephen Lewis: Canada  United Nations Special Envoy for
HIV/AIDS in Africa

Alireza Marandi: Iran  Professor of Pediatrics at Shaheed
Behesti University, Tehran; former Minister of Health and
Medical Education, Islamic Republic of Iran

Michael Marmot: UK  Commission Chair and Director,
International Centre for Health and Society, University
College London

Charity Ngilu: Kenya  Minister of Health, Kenya

Hoda Rashad: Egypt  Research Professor and Director, Social
Research Centre, American University of Cairo; Member of El
Shoura Council of the Senate

Amartya Sen: India  1998 Nobel laureate in economics; Lamont
University Professor, Harvard University, Cambridge

David Satcher: USA  Interim President of the Morehouse
School of Medicine, Atlanta, Georgia; former Surgeon General
of the USA

Anna Tibaijuka: Tanzania  Executive-Director, UN-HABITAT

Denny Vagero: Sweden  Director of the Centre for Health
Equity Studies (CHESS), Stockholm University/ Karolinska
Institute


 © World Health Organization 2005. All rights reserved

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