Health inequity and its social determinants: A sociological commentary

In 2005, the World Health Organisation (WHO) established the Commission on the Social Determinants of Health. It is to produce its final report in May 2008, identifying actions to address the vast health disparities that have accompanied global economic expansion and widespread political turmoil. The Commission and its anticipated report are a major part of a new research and policy approach committed to the advancement of global health equity. This paper explores the fundamental goals, principles and concepts of the health equity 'movement', and its relationship to the 'social determinants of health' approach. It argues that such an approach is an instrument for rendering the problem of health inequity real and actionable by institutional authorities and policy practitioners. However, its prevailing frameworks and methods impose significant constraints on its capacity to identify effectively the mechanisms by which health inequities are produced. Accordingly, the actions suggested by the prevailing approach to the problem of health inequity are likely to be less than efficacious. The paper suggests that a more dynamic understanding of the social, as provided by critical sociology, has much to offer in advancing efficacious policy interventions in the field of health and equity.