Social and environmental determinants of health inequalities
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University of Glasgow MRC/CSO Social and Public Health Sciences Unit University of Glasgow Berkeley Square 99 Berkeley Street Glasgow G3 7HR United Kingdom
Centro de Integração de Dados e Conhecimentos para Saúde (Cidacs/Fiocruz), Brazil
St George’s University of London, United Kingdom
Universidad Internacional del Ecuador Ecuador
Publication date: 2023-04-26
Popul. Med. 2023;5(Supplement):A864
Outline we provoke a discussion based on our experience of working in brazil and ecuador, where we have a unit focused on the social and environmental determinants of health inequalities:
Health inequalities are in large part attributable to the social determinants of health – the conditions in which people are born, grow, work, live, age and die. Many environmental factors, including urbanisation and the climate emergency, are increasing priorities for individual and population health. These tend to have the most harmful impacts on the most deprived in society. The health system needs to respond to such social and environmental threats, but its organisation may mean that it is not protecting the most vulnerable in society. To try to reduce the impact of social conditions such as poverty, many governments (particularly in Latin America) have introduced policies such as conditional cash transfers or housing programmes for the very poor. Similarly, governments may introduce environmental policies to protect the environment and mitigate any harmful effects on living conditions. While such policies may not be primarily aimed at improving health, they may still have large impacts on health and health inequalities, and much of the historical improvement in life expectancy attributable to these policies. There are many axes along which we can measure health inequalities, including income, ethnicity, race, sex, geography, migration, urbanicity and deprivation. Focusing on reducing inequalities in any one dimension to the exclusion of the others runs the risk of increasing inequalities in the other axes. Aims and objectives The aim of this workshop is to encourage thinking around how non-health sector policies may be used to reduce health inequalities, particularly in low and middle income countries. Following a brief introduction to each of a series of key questions (see below), participants in the workshop will discuss ways in which social and environmental policy can reduce health inequalities and how such impacts can be evaluated.

Key questions:
Why does health equity matter rather than health improvement? Why focus on policy to reduce health inequalities? What does non-health sector policy have to do with health inequalities? How can we evaluate the impact of policies on inequalities in health?

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