This recently published review follows up on the 2008 Commission on the Social Determinants of Health (CSDH). It details health inequalities across the 53 member states of the WHO-Europe region, and was commissioned to support Health 2020. It builds on global evidence and recommends policies to reduce health inequities across all countries, and was developed by a large consortium of experts including Peter Goldblatt, Hynek Pikhart, Olle Lundberg and Johannes Siegrist who are involved in DRIVERS.
The review is divided into four main sections: 1) Context and background to the review with key principles underpinning the recommendations, 2) Summary of current evidence on the health divide between countries, 3) A focus on the life-course perspective, wider society, macro-level context, governance, delivery and monitoring systems, 4) Implementation, framework for action, reasons for failure, guidance on good practice.
Overall, the report calls for universal coverage of health care, a focus on health-adverse behaviours, and action on the conditions into which people are born, grow, live, work and age, and the inequalities in power, money and resources that give rise to them.
New themes in the report, compared with the CSDH, include:
- Emphasis on human rights as an approach to tackle the SDH and improve health but continued commitment to social justice.
- Emphasis on empowering communities and individuals to take action.
- Emphasis on the life-course approach, meaning that although early childhood is important every stage of life plays a subsequent part in determining health.
- Emphasis on protecting future generations from perpetuations of social and economic inequalities.
