3/21/2023 0 Comments Brave church derek carr![]() ![]() audiences ( 17, 91).Īn increasing focus among U.S. ![]() Systematic efforts have disseminated this knowledge and made it compelling for broader U.S. Incremental improvements in health with increasing social advantage have now been observed in the United States ( 14) as well as in Europe ( 69, 92), indicating the relevance of SDOH for middle-class as well as the most disadvantaged Americans. Notable recent initiatives include the World Health Organization (WHO) Commission on the Social Determinants of Health ( 122), the MacArthur Foundation Network on Socioeconomic Status and Health ( 111), and the Robert Wood Johnson Foundation (RWJF) Commission to Build a Healthier America ( 91). This growing momentum reflects a confluence of several phenomena: First, an accumulating critical mass of knowledge in social and biomedical sciences from the United States and other countries ( 1, 10, 123) has led to increased understanding of how social factors influence health and has enhanced the scientific credibility of relevant efforts. Research priorities include measuring social factors better, monitoring social factors and health relative to policies, examining health effects of social factors across lifetimes and generations, incrementally elucidating pathways through knowledge linkage, testing multidimensional interventions, and addressing political will as a key barrier to translating knowledge into action. ![]() We review current knowledge about health effects of social (including economic) factors, knowledge gaps, and research priorities, focusing on upstream social determinants-including economic resources, education, and racial discrimination-that fundamentally shape the downstream determinants, such as behaviors, targeted by most interventions. A critical mass of relevant knowledge has accumulated, documenting associations, exploring pathways and biological mechanisms, and providing a previously unavailable scientific foundation for appreciating the role of social factors in health. In the United States, awareness is increasing that medical care alone cannot adequately improve health overall or reduce health disparities without also addressing where and how people live. ![]()
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