Primary health care and the social determinants of health: essential and complementary approaches for reducing inequities in health
- 1Department of Ethics, Equity, Trade and Human Rights, World Health Organization, Geneva, Switzerland
- 2Health Systems and Services Cluster, World Health Organization, Geneva, Switzerland
- 3Centre for Public Health Research, Massey University, Wellington, New Zealand
- 4Information, Evidence and Research Cluster, World Health Organization, Geneva, Switzerland
- Correspondence to Kumanan Rasanathan, Department of Ethics, Equity, Trade and Human Rights, World Health Organization, Avenua Appia 20, CH-1211 Geneva 27 Switzerland; rasanathank{at}who.int
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Contributors KR and EVM conceived the study. KR wrote the first draft. KR, EVM, DM, CE and TE critically revised the manuscript. All authors approved the final manuscript.
- Accepted 29 October 2009
- Published Online First 22 November 2009
Abstract
Increasing focus on health inequities has brought renewed attention to two related policy discourses - primary health care and the social determinants of health. Both prioritise health equity and also promote a broad view of health, multisectoral action and the participation of empowered communities. Differences arise in the lens each applies to the health sector, with resultant tensions around their mutual ability to reform health systems and address the social determinants. However, pitting them against each is unproductive. Health services that do not consciously address social determinants exacerbate health inequities. If a revitalised primary health care is to be the key approach to organise society to minimise health inequities, action on social determinants has to be a major constituent strategy. Success in reducing health inequities will require ensuring that the broad focus of primary health care and the social determinants is kept foremost in policy - instead of the common historical experience of efforts being limited to a part of the health sector.
Footnotes
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See Commentary, p 653
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Disclaimer The views in this paper represent those of the authors and should not be ascribed to their institutions.
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Competing interests KR, EVM, CE and TE are WHO staff. KR, EVM, DM and TE contributed to the work of the Commission on Social Determinants of Health. All authors contributed to the WHO World Health Report 2008.
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Provenance and peer review Not commissioned; externally peer reviewed.
