This stream is initiated by Luigi Resegotti, CIPES Piemonte
What we mean by social determinants of health
Abstract:
In his editorial in the first issue of Global Health Promotion, Maurice Mittelmark invites to open an Online dialogue starting from Navarro’s address presented at the IUHPE Conference in Turin, on 9 September 2008 and, as one of the promoters of that Conference, I would like to put forward some comments on the vision of health promotion underlying this presentation. Personally I believe that health promotion should look more to what joins rather than to what divides people; that it should be more a matter for dreamers than for ideologists. I understand very well Navarro’s point that there is a big discrepancy between what is being said and what is being made by many Governments and International Organisations for facing the social determinants of health but I wonder whether rejecting the work of the WHO Commission on Social Determinants of Health as mere theoretical is helpful for promoting health for all. Perhaps class analysis is not antiquated, but certainly is useless for addressing health inequities. Navarro’s example of the law of gravity is not pertinent. Even if the law of gravity holds true we have learned how to reach the moon. It is not a matter of classes, is a matter of persons. Irrespective of the class to which they belong, individuals who are more concerned with their own power than with human wellbeing are the true opponents to health for all in the 21th century. No matter if they are neoliberal or Marxist. Navarro underpins the lack of health care for millions of Americans who do not have any form of health benefit coverage and the inability to pay medical bills as one of the main causes of preventable deaths, but in many European Countries like Italy where the National Health Systems provides free care for everybody, preventable deaths are still a big problem mainly related to environmental factors like toxic emissions and wastes, traffic and work accidents, non healthy agriculture, incorrect alimentation and health promotion must take into account all these non medical determinants. Let make a final comment: if 82% of the population in USA believes that the Government does not represent their interest they can elect a different Government, if many European are not happy about the policy of the EU, they can elect a different parliament. But EU is a useful tool for closing the gap in health in Europe. Health cannot be promoted by hate but only by love. Only if you learn to say to everybody in the word “You interest me” you will become a true health promoter.
Luigi Resegotti CIPES Piemonte Turin Italy
cipes@cipespiemonte.it
