Social Determinants of Health

Published on Dec 4, 2014

Prof. Sir Michael Marmot, from the University College London, on the Social Determinants of Health. Talk delivered at the ZURICH.MINDS Annual Symposium 2014. Health Inequalities. Symposium Curated by Rolf Dobelli

Published on Jul 12, 2012

Published on Nov 11, 2013

There are many factors that interfere with health equity and the ability of patients to get their health care needs met. For patients with complex lives and complex health needs, these challenges are even more pronounced. These social determinants of health, such as income, education, transportation, housing, and race or ethnicity, have a powerful influence on a patient’s life long before they arrive at a hospital or clinic.

Learn more:

Published on Nov 15, 2012

Public Health Ontario

Commission on Social Determinants of Health – final report

Excerpted from:

Closing the gap in a generation: Health equity through action on the social determinants of health

Social justice is a matter of life and death. It affects the way people live, their consequent chance of illness, and their risk of premature death. We watch in wonder as life expectancy and good health continue to increase in parts of the world and in alarm as they fail to improve in others.

Download the full report – English [pdf 7.28Mb]

Executive summary – English [pdf 4.25Mb]

The report in sections

Regional reports on Social Determinants of Health

‘Fair Society Healthy Lives’ (The Marmot Review) – IHE

Excerpted from:

Report abstract

In November 2008, Professor Sir Michael Marmot was asked by the then Secretary of State for Health to chair an independent review to propose the most effective evidence-based strategies for reducing health inequalities in England from 2010.

The final report, ‘Fair Society Healthy Lives‘, was published in February 2010, and concluded that reducing health inequalities would require action on six policy objectives:

  • 1. Give every child the best start in life
  • 2. Enable all children, young people and adults to maximise their capabilities and have control over their lives
  • 3. Create fair employment and good work for all
  • 4. Ensure healthy standard of living for all
  • 5. Create and develop healthy and sustainable places and communities
  • 6. Strengthen the role and impact of ill-health prevention.

The executive summary and framework of indicators are available above. Some other documents are also available:

Key Messages of ‘Fair Society Healthy Lives’

Task Group Reports

Presentations and the graphs from the full report

Summary of Views from the consultation

Background paper: a report of the qualitative findings from focus groups with deprived groups

– Economic Costs:

i. economic analysis

ii. economic benefits of health inequality reduction

iii. overall costs of health inequalities

 To mark one year since the publication of ‘Fair Society Healthy Lives’, the Marmot Review Team and the London Health Observatory produced baseline figures for some key indicators of the social determinants of health, health outcomes and social inequality that correspond, as closely as is currently possible, to the indicators proposed in Fair Society, Healthy Lives. There is more information available here.

By The Marmot Review Team Feb 2010

A conceptual framework for action on the social determinants of health

Excerpted from:

Publication details

Number of pages: 76 p.

Publication date: November, 2010

Languages: English

ISBN: 978 92 4 150085 2



A first draft of this paper was prepared for the May 2005 meeting of the Commission on Social Determinants of Health held in Cairo. In the course of discussions the members and the Chair of the CSDH contributed substantive insights and recommended the preparation of a revised draft, which was completed and submitted to the CSDH in 2007. The authors of this paper are Orielle Solar and Alec Irwin.

Healthy People 2020 Approach to Social Determinants of Health

Excerpted from:

A “place-based” organizing framework, reflecting five (5) key areas of social determinants of health (SDOH), was developed by Healthy People 2020.

These five key areas (determinants) include:

  • Economic Stability
  • Education
  • Social and Community Context
  • Health and Health Care
  • Neighborhood and Built Environment


 Each of these five determinant areas reflects a number of critical components/key issues that make up the underlying factors in the arena of SDOH.

  • Economic Stability
    • Poverty
    • Employment
    • Food Security
    • Housing Stability
  • Education
    • High School Graduation
    • Enrollment in Higher Education
    • Language and Literacy
    • Early Childhood Education and Development
  • Social and Community Context
    • Social Cohesion
    • Civic Participation
    • Discrimination
    • Incarceration
  • Health and Health Care
  • Neighborhood and Built Environment
    • Access to Healthy Foods
    • Quality of Housing
    • Crime and Violence
    • Environmental Conditions

This organizing framework has been used to establish an initial set of objectives for the topic area as well as to identify existing Healthy People objectives (i.e., in other topic areas) that are complementary and highly relevant to social determinants. It is anticipated that additional objectives will continue to be developed throughout the decade.

In addition, the organizing framework has been used to identify an initial set of evidence-based resources and other key tools/examples of how a social determinants approach is or may be implemented at a state and local level.