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The report by the World Health Organization’s (WHO) Commission on Social Determinants of Health (CSDH) (Closing the gap in a generation: health equity through action on the social determinants of health)1 was launched on 28 August this year. In this issue, timed to coincide with a conference of the same name being held in London in November, we include two papers relevant to the CSDH’s work. First, a paper by Marmot (Chair of the CSDH) and Friel (CSDH staff) reflecting on some media responses in the first week following the report’s launch on how social justice is appropriately an explicit foundation for the work of the CSDH, and the process of collating evidence on how to address the social determinants of health (inequity). (see page 1095)2 Second, we include a paper by Krieger on the use of iconography (“the illustration of a subject by drawings or figures”, The concise Oxford dictionary) to depict models of the social determinants of health and health inequalities. (see page 1098)3
All of us involved in research or policy advice on health or health inequalities use framework diagrams of one sort or another to help portray our assumptions and logic. A very commonly used diagram is the Dahlgren and Whitehead “main determinants of health” diagram, which depicts individuals surrounded by layers of lifestyles, social and community networks, living and working conditions and general socioeconomic, cultural and environmental conditions.4 This diagram was developed to depict the social determinants of health—not the determinants of social inequalities in health. Yet, it has widely been used as a model of both health and health inequalities. Indeed, I can speak to this personally. In 1997 I was a co-author of a report by the New Zealand Ministry of Health that included this …
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