The Social Determinants of Health- Its Time to Consider The Causes of the Causes.pdf

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The Social Determinants of Health: It's Time to Consider the Causes of the Causes Author(s): Paula Braveman and Laura Gottlieb Source: Public Health Reports (1974-), Vol. 129, SUPPLEMENT 2: Nursing in 3D: Workforce Diversity, Health Disparities, and Social Determinants of Health (JANUARY/FEBRUARY 2014), pp. 19-31 Published by: Sage Publications, Inc. Stable URL: Accessed: 09-10-2019 20:06 UTC JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, and build upon a wide range of content in a trusted digital archive. We use information technology and tools to increase productivity and facilitate new forms of scholarship. For more information about JSTOR, please contact [email protected] Your use of the JSTOR archive indicates your acceptance of the Terms & Conditions of Use, available at Sage Publications, Inc. is collaborating with JSTOR to digitize, preserve and extend access to Public Health Reports (1974-) This content downloaded from 141.211.4.224 on Wed, 09 Oct 2019 20:06:59 UTC All use subject to
Nursing in 3D: Diversity, Disparities, and Social Determinants The Social Determinants of Health: It's Time to Consider the Causes of the Causes Paula Braveman, MD, MPHa Laura Gottlieb, MD, MPHb ABSTRACT During the past two decades, the public health community's attention h drawn increasingly to the social determinants of health (SDH)—the factor from medical care that can be influenced by social policies and shape he in powerful ways. We use "medical care" rather than "health care" to ref clinical services, to avoid potential confusion between "health" and "hea care." The World Health Organization's Commission on the Social Determ nants of Health has defined SDH as "the conditions in which people are grow, live, work and age" and "the fundamental drivers of these conditi The term "social determinants" often evokes factors such as health-related features of neighborhoods (e.g., walkability, recreational areas, and accessibil ity of healthful foods), which can influence health-related behaviors. Evidence has accumulated, however, pointing to socioeconomic factors such as income, wealth, and education as the fundamental causes of a wide range of health outcomes. This article broadly reviews some of the knowledge accumulated to date that highlights the importance of social—and particularly socioeconomic— factors in shaping health, and plausible pathways and biological mechanisms that may explain their effects. We also discuss challenges to advancing this knowledge and how they might be overcome. "University of California, San Francisco, School of Medicine, Department of Family and Community Medicine, Center on Social Disparities in Health, San Francisco, CA bUniversity of California, San Francisco, School of Medicine, Department of Family and Community Medicine, Center for Health and Community, San Francisco, CA Address correspondence to: Paula Braveman, MD, MPH, University of California, San Francisco, School of Medicine, Department of Family and Community Medicine, Center on Social Disparities in Health, PO Box 0943, 3333 California St., Ste. 365, San Francisco, CA

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