Ten Tips for American Health Researchers and Health Workers
Dennis Raphael, York University, September, 2006

1.  Recognize that social determinants of health such as income and its
distribution, employment security and working conditions, health and social
services, and housing and food security are the primary determinants of
population health and the source of health inequalities.

2. Consider that the USA - despite being the 2nd wealthiest nation (behind
Luxembourg) in per capita gross domestic product - has one of the worst
population health profiles among wealthy - and some not so wealthy -
developed nations.

3. Reflect upon the reality that public policy in the USA is among the
least developed and among the most threatening to the overall population
health of its citizens among wealthy developed nations.

4. Accept the finding that these shortcomings in health supporting public
policy interact with class, race, and gender to create profound
inequalities in health among Americans.

5. Explore and integrate developments in population health, public policy
in support of health, and the social determinants of health that are being
developed in other nations into American health policy.

6. Demand that governmental authorities support research into the impacts
of the social determinants of health and their public policy antecedents.
Data collection that includes income and class data as well as indicators
of other living conditions is imperative.

7.  Recognize that health policy will always be "political." The task is to
provide a politics of health rather than a politics of disease.

8. Stand up to the political forces that consider such intellectual
inquiries as "un-American" and "promoting class warfare."

9. Urge your professional organizations and health and service agencies to
support a new, broadened health policy agenda.

10. Communicate the importance of these health policy issues to your fellow
Americans.

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