Centre of Social Medicine and Community Health

The book looks at effortsto address the social determinants of health and equity in large-scale public health programmes, and the challenges that arise during implementation. Addressing the social determinants of health and equity in large-scale public health programmes, including infectious disease control efforts, is challenging and research on the implementation of such programmes is scarce. Four case studies of the case studies, which were funded and overseen by TDR, present experiences with different programmes targeting infectious diseases in Tanzania, South Africa, Nigeria and Indonesia. The primary objective of undertaking these case studies was to review their implementation processes and to draw lessons that can be learned by others embarking on the difficult path to correct inequities in health by addressing the social determinants.

The case studies focused on the five types of implementation: going to scale, managing policy change, managing intersectoral processes, adjusting design, and ensuring sustainability. Among the key messages emerging from the study: the importance of evidence and establishing baseline data; that in the long haul, the battle for equity takes place in the public space through intelligent use of the evidence and partners; and finally, that scale-up should consider three phases – providing proof of principle, testing the scalability of the programme with particular focus on the drivers of expansion and how to transfer the values torch, and roll-out with systematic monitoring, repeated evaluation and timely adjustments to the programme.

http://whqlibdoc.who.int/publications/2011/9789241564137_eng.pdf

This book is a collection of analyses of the social determinants of health that impact on specific health conditions. Stemming from the recommendations of the Commission on Social Determinants of Health, promising interventions to improve health equity are presented for the areas of: alcohol-related disorders, cardiovascular diseases, child health and nutrition, diabetes, food safety, maternal health, mental health, neglected tropical diseases, oral health, pregnancy outcomes, tobacco and health, tuberculosis, and violence and injuries.

The book was commissioned by the Department of Ethics, Equity, Trade and Human Rights as part of the work undertaken by the Priority Public Health Conditions Knowledge Network of the Commission on Social Determinants of Health, in collaboration with 16 of the major public health programmes of WHO.

http://whqlibdoc.who.int/publications/2010/9789241563970_eng.pdf

Synergy for equity 14 Erik Blas and Anand Sivasankara Kurup Contents 14.1 Levels and patterns of social gradients 262 14.2 Social determinants at play...... 264 14.3 From promising entry-points to proposals for action.......... 264 Socioeconomic context and position..... 265 Differential ...

Improved tuberculosis (TB) diagnosis and treatment
through the DOTS and Stop TB strategies have saved
millions of lives; however, their impact on TB incidence
has been disappointing and the scale of the epidemic remains
overwhelming. To reduce the incidence of TB, the
drivers of the epidemic and social determinants of TB
need to be addressed. These include co-morbidities and
substance use and, moreover, the social and economic
conditions that determine both the course of the TB epidemic
and exposure to these risk factors.

......

Action on the social determinants can be categorised in terms of
health-sector interventions, intersectoral policies impacting
across society, and measurement and research to
better understand inequities and links between TB and
other factors. TB programmes cannot carry out these
actions alone; however, they can make important contributions
in the delivery of interventions and in advocating
and negotiating for intersectoral efforts. The considerable
progress seen in the clinical care of TB needs to
be sustained; however, the attainment of TB targets, including
elimination by 2050, will require expansion of
the lens of TB control efforts beyond ‘business as usual’
to address the social determinants of the disease.

BACKGROUND: Vaccination against influenza is considered the most important public health intervention to prevent unnecessary hospitalizations and premature deaths related to influenza in the elderly, though there are significant inequities among global influenza vaccine resources, capacities, and policies. The objective of this study was to assess the social determinants of health preventing adults >= 65 years old from accessing and accepting seasonal influenza vaccination.METHODS: A systematic search was performed in January 2011 using MEDLINE, ISI -- Web of Science, PsycINFO, and CINAHL (1980--2011). Reference lists of articles were also examined. Selection criteria included qualitative and quantitative studies written in English that examined social determinants of and barriers against seasonal influenza vaccination among adults >= 65 years. Two authors performed the quality assessment and data extraction. Thematic analysis was the main approach for joint synthesis, using identification and juxtaposition of themes associated with vaccination.RESULTS: Overall, 58 studies were analyzed. Structural social determinants such as age, gender, marital status, education, ethnicity, socio-economic status, social and cultural values, as well as intermediary determinants including housing-place of residence, behavioral beliefs, social influences, previous vaccine experiences, perceived susceptibility, sources of information, and perceived health status influenced seasonal influenza vaccination. Healthcare system related factors including accessibility, affordability, knowledge and attitudes about vaccination, and physicians' advice were also important determinants of vaccination.CONCLUSIONS: Our results demonstrate that the ability of adults >=65 years to receive seasonal influenza vaccine is influenced by structural, intermediate, and healthcare-related social determinants which have an impact at the health system, provider, and individual levels.