The Social Determinants of Health: Time to Re-Think?

Int J Environ Res Public Health. 2020 Aug 12;17(16):5856. doi: 10.3390/ijerph17165856.


Twelve years have now passed since the influential WHO Report on the Social Determinants of Health (SDoH) in 2008. A group of senior international public health scholars and decision-makers met in Italy in mid-2019 to review the legacy of the SDoH conceptual framework and its adequacy for the many challenges facing our field as we enter the 2020s. Four major categories of challenges were identified: emerging "exogenous" challenges to global health equity, challenges related to weak policy and practice implementation, more fundamental challenges related to SDoH theory and research, and broader issues around modern research in general. Each of these categories is discussed, and potential solutions offered. We conclude that although the SDoH framework is still a worthy core platform for public health research, policy, and practice, the time is ripe for significant evolution.

Keywords: health policy; health promotion; social determinants of health.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Health Equity*
  • Health Policy
  • Italy
  • Public Health
  • Social Determinants of Health*