Intended for healthcare professionals


The political determinants of health—10 years on

BMJ 2015; 350 doi: (Published 08 January 2015) Cite this as: BMJ 2015;350:h81
  1. Ilona Kickbusch, director
  1. 1Global Health Programme, Graduate Institute for International and Development Studies, Geneva, Switzerland
  1. kickbusch{at}

Public health professionals need to become more politically astute to achieve their goals

Health is a political choice, and politics is a continuous struggle for power among competing interests. Looking at health through the lens of political determinants means analysing how different power constellations, institutions, processes, interests, and ideological positions affect health within different political systems and cultures and at different levels of governance. Bambra et al provide three arguments why health is political1: health is unevenly distributed, many health determinants are dependent on political action, and health is a critical dimension of human rights and citizenship.

Political action on poverty and global health inequalities was the key message given by the first alternative world health report in 2005,2 and it remains the focus of many civil society organisations in global health. In 2008, the final report of the Commission on Social Determinants of Health3 also concluded with the political message that health is shaped ultimately by factors such as “the distribution of money, power and resources at global, national and local levels”—all of which can be tackled only in sectors other than health.

There is currently …

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