The surveillance of social determinants of health

Social determinants of health are major factors responsible for a population's health and health inequalities.1 Public health surveillance was originally developed for the control of infectious diseases, but today its principles have also been applied to other public health problems such as chronic diseases and occupational and traffic injuries.2 Many countries already collect data on social determinants of health, dispersed across different information systems typically designed for other purposes. However, most social determinants of health remain outside surveillance systems and this area of public health remains limited or marginal within mainstream policy practice. Surveillance of social determinants of health is therefore a neglected but essential and challenging public health issue. The WHO Commission on Social Determinants of Health strongly recommended the creation of National Health Equity Surveillance Systems, with routine data collection on the social determinants of health and health equity, and investment in training of policy-makers and health practitioners in equity monitoring and health equity impact assessment.1 Such investment was given further priority by international organisations and member states through the adoption of a World Health Assembly Resolution on social determinants of health in May 2009, and further reaffirmed in the Rio Political Declaration on Social Determinants of Health in October 2011.3 Likewise, the former Spanish Minister of Health and Social Policy launched ‘Innovation in Public Health: Monitoring Social Determinants of Health and Reduction of Health Inequalities’ as a top priority for the Spanish presidency of the European Union in the first semester of 2010.4 In spite of these initiatives, however, today there is no comprehensive surveillance system capable of globally or nationally monitoring social determinants and their relationship with health inequalities. …