Feature Poverty and health

Improving health through wealth

BMJ 2007; 335 doi: https://doi.org/10.1136/bmj.39282.431100.AD (Published 13 September 2007) Cite this as: BMJ 2007;335:538
  1. Lynn Eaton, journalist
  1. London E17 9SB
  1. lynn{at}lynneaton.co.uk

    This week, the WHO's Commission on the Social Determinants of Health has set out its vision for tackling health inequity. Lynn Eaton looks at one project that has put social determinants at the top of the agenda and how the commission is working

    It's more than two years since the Make Poverty History campaign was launched, in January 2005, with the razzamatazz of pop stars, politicians, and the public flaunting their white wrist bands and calling on world leaders to tackle the root causes of poverty.

    As pop star Bono, who was involved in the campaign, said at the time: “We can make extreme poverty history, I really believe that. The kind of stupid poverty where kids are dying for the lack of an immunisation that costs 20 cents, or for lack of food in a world of plenty. Don't we want to be the generation that says no to that?”

    Against this groundswell in public opinion, the World Health Organization set up its Commission on the Social Determinants of Health in March 2005—albeit with a lot less fanfare. Its brief was to investigate the social factors that affect health, including unemployment, unsafe workplaces, urban slums, globalisation, and lack of access to health systems.

    For many governments exposing the links between wealth and health is unpalatable—especially in societies based on capitalist models. In the UK, for instance, former prime minister Margaret Thatcher sought to bury Douglas Black's report on the inequalities of health.1

    Organisations like WHO and the Bill and Melinda Gates Foundation, meanwhile, have tended to take a disease based approach to health—offering treatments for tuberculosis or HIV infection but often failing to consider the social context in which these treatments are given. It's an approach adopted by many governments too, and one that continues to frustrate practitioners …

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