Peer-reviewed general biomedical journal
Analysis
Medwave 2015 Oct;15(9):e6289 doi: 10.5867/medwave.2015.09.6289
The challenge for healthcare systems in the XXI century: how to incorporate the focus of social determinants in healthcare?
Cristóbal Cuadrado
Key Words: social determinants of health, delivery of health care
Abstract
During the 20th century, a series of reflections on the role of biomedicine and social factors in the concept of health and disease processes served as a necessary prelude to the conceptual and empirical development of what later became known as the social determinants of health. In relation to this perspective, the question arises: What is the role of modern health systems from the perspective of the social determinants of health? This article presents an alternative view of the role of health systems from the focus of the social determinants of health, raising its importance and influence on the structural level, while addressing its implications as an intermediary determinant of health inequalities.
This article does not have an English version.
Esta obra de Medwave está bajo una licencia Creative Commons Atribución-NoComercial 3.0 Unported. Esta licencia permite el uso, distribución y reproducción del artículo en cualquier medio, siempre y cuando se otorgue el crédito correspondiente al autor del artículo y al medio en que se publica, en este caso, Medwave.
Durante el siglo XX una serie de discusiones sobre el rol de lo biomédico y lo social en los procesos de salud y enfermedad, sirvieron de necesario preámbulo para el desarrollo conceptual y empírico de lo que posteriormente se conocería como los determinantes sociales de la salud. En relación a esta perspectiva, surge la pregunta ¿cuál puede ser el rol de los sistemas de salud modernos desde una perspectiva de los determinantes sociales de la salud? El presente artículo plantea una mirada alternativa al rol de los sistemas de salud, desde el enfoque de los determinantes sociales de la salud. Además, plantea su importancia e influencia a nivel estructural, sin dejar de abordar antes sus implicancias como determinante intermediario en las inequidades de la salud.
Authors:
Cristóbal Cuadrado[1]
Affiliation:
[1] Programa de Políticas, Sistemas y Gestión en Salud, Escuela de Salud Pública, Universidad de Chile, Santiago, Chile
E-mail: cristobalcuadrado@med.uchile.cl
Author address:
[1] Avenida Independencia 939
Santiago
Chile
Citation: Cuadrado C. The challenge for healthcare systems in the XXI century: how to incorporate the focus of social determinants in healthcare?. Medwave 2015 Oct;15(9):e6289 doi: 10.5867/medwave.2015.09.6289
Submission date: 1/9/2015
Acceptance date: 8/10/2015
Publication date: 20/10/2015
Origin: not requested
Type of review: reviewed by two external peer reviewers, double-blind
Comments (0)
We are pleased to have your comment on one of our articles. Your comment will be published as soon as it is posted. However, Medwave reserves the right to remove it later if the editors consider your comment to be: offensive in some sense, irrelevant, trivial, contains grammatical mistakes, contains political harangues, appears to be advertising, contains data from a particular person or suggests the need for changes in practice in terms of diagnostic, preventive or therapeutic interventions, if that evidence has not previously been published in a peer-reviewed journal.
No comments on this article.
To comment please log in
Medwave provides HTML and PDF download counts as well as other harvested interaction metrics. There may be a 48-hour delay for most recent metrics to be posted.
- Wilson HJ. The myth of objectivity: is medicine moving towards a social constructivist medical paradigm? Fam Pract. 2000 Apr;17(2):203-9. | PubMed |
- Navarro V. Concepto actual de la salud pública. In: Martínez F, Antó JM, Castellanos P, Gili M, Marset P, Navarro V, editors. Salud Pública. Madrid: Mc Graw Hil; 1998: 49-54. | Link |
- Mackenbach JP. Politics is nothing but medicine at a larger scale: reflections on public health's biggest idea. J Epidemiol Community Health. 2009 Mar;63(3):181-4. | CrossRef | PubMed |
- McKeown T. Medical issues in historical demography. Int J Epidemiol. 2005 Jun;34(3):515-20. | PubMed |
- Szreter S. The Importance of Social Intervention in Britain’s Mortality Decline c. 1850-1914: a re-interpretation of the role of public health. Soc Hist Med. 1988;(1):1-23 | Link |
- Harris B. Public health, nutrition, and the decline of mortality: the McKeown thesis revisited. Soc Hist Med. 2004;17(3):379-407. | Link |
- Grundy E. Commentary: The McKeown debate: time for burial. Int J Epidemiol. 2005 Jun 34(3):529-33. | PubMed |
- Colgrove J. The McKeown thesis: a historical controversy and its enduring influence. Am J Public Health. 2002 May;92(5):725-9. | PubMed |
- Link BG, Phelan JC. McKeown and the idea that social conditions are fundamental causes of disease. Am J Public Health. 2002 May;92(5):730-2. | PubMed |
- McKinlay JB, McKinlay SM. The questionable contribution of medical measures to the decline of mortality in the United States in the twentieth century. Milbank Mem Fund Q Health Soc. 1977 Summer;55(3):405-28. | PubMed |
- Lalonde M. A new perspective on the health of canadians - A working document. Ottawa, Canada; 1974:1-77.
- Lalonde M. New perspective on the health of Canadians: 28 years later. Rev Panam Salud Publica. 2002 Sep;12(3):149-52. | PubMed |
- Gray AM. Inequalities in health. The Black Report: a summary and comment. Int J Health Serv. 1982;12(3):349-80. | PubMed |
- Marmot M. Social determinants of health inequalities. Lancet. 2005 Mar 19-25;365(9464):1099-104 | PubMed |
- Irwin A, Valentine N, Brown C, Loewenson R, Solar O, Brown H, et al. The commission on social determinants of health: tackling the social roots of health inequities. PLoS Med. 2006 May;3(6):e106. | PubMed |
- Lee J, Sadana R. Improving equity in health by addressing social determinants [Internet]. Geneva: World Health Organization. Geneva: World Health Organization; 2011. | Link |
- Gilson L, Doherty J, Loewenson R, Francis V. Challenging inequity trought heath systems - final report. Knowledge network on health systems. 2007: 1-146. | Link |
- Commission on Social Determinants of Health. Closing the gap in a generation: health equity trough action on the social determinants of health. Final Report of the Commission on Social Determinants of Health. Geneva: WHO; 2008:1-256. | Link |
- Solar O, Irwin A. A conceptual framework for action on the social determinants of health. Production. Geneva: WHO; 2010: 1-79. | Link |
- Frenz P, Vega J. Universal health coverage with equity : what we know, don’t know and need to know. accelerate universal health coverage. Montreux, Zwitzerland:WHO; 2010:1-56. | Link |
- Marmot M. Universal health coverage and social determinants of health. Lancet. 2013 Oct 12;382(9900):1227-8. | CrossRef | PubMed |
- Frenz P, Delgado I, Kaufman JS, Harper S. Achieving effective universal health coverage with equity: evidence from Chile. Health Policy Plan. 2014 Sep;29(6):717-31. | CrossRef | PubMed |
- Nye J. Soft power. Foreign Policy. 1990;80:153–71. | Link |
- Navarro V. What we mean by social determinants of health. Glob Health Promot. 2009 Mar;16(1):5-16. | CrossRef | PubMed |
- Gopinathan U, Cuadrado C, Watts N, Guinto RR, Hougendobler D, Wanjau W, et al. The political origins of health inequity: the perspective of the Youth Commission on Global Governance for Health. Lancet. 2014 Feb 15;383(9917):e12-3. | CrossRef | PubMed |
- World Health Organization. Declaration of Alma-Ata. Report of the International Conference on Primary Health Care. Geneva:WHO; 1978:1-77. | Link |
- Rasanathan K, Montesinos EV, Matheson D, Etienne C, Evans T. Primary health care and the social determinants of health: essential and complementary approaches for reducing inequities in health. J Epidemiol Community Health. 2011 Aug;65(8):656-60. | CrossRef | PubMed |
- Maeseneer M, Willems S, De Sutter M, Van de Geucchte I, Billings M. Primary health care as a strategy for achieving equitable care: a literature review commissioned by the Health Systems Knowledge Network. 2007:1-42. [on line]. | Link |
- Law I, Widdows H. Health Care Anal. Conceptualising health: insights from the capability approach. 2008 Dec;16(4):303-14. | PubMed |
- Entwistle VA, Watt IS. Treating patients as persons: a capabilities approach to support delivery of person-centered care. Am J Bioeth. 2013;13(8):29-39. | CrossRef | PubMed |
Wilson HJ. The myth of objectivity: is medicine moving towards a social constructivist medical paradigm? Fam Pract. 2000 Apr;17(2):203-9. | PubMed |Navarro V. Concepto actual de la salud pública. In: Martínez F, Antó JM, Castellanos P, Gili M, Marset P, Navarro V, editors. Salud Pública. Madrid: Mc Graw Hil; 1998: 49-54. | Link |Mackenbach JP. Politics is nothing but medicine at a larger scale: reflections on public health's biggest idea. J Epidemiol Community Health. 2009 Mar;63(3):181-4. | CrossRef | PubMed |McKeown T. Medical issues in historical demography. Int J Epidemiol. 2005 Jun;34(3):515-20. | PubMed |Szreter S. The Importance of Social Intervention in Britain’s Mortality Decline c. 1850-1914: a re-interpretation of the role of public health. Soc Hist Med. 1988;(1):1-23 | Link |Harris B. Public health, nutrition, and the decline of mortality: the McKeown thesis revisited. Soc Hist Med. 2004;17(3):379-407. | Link |Grundy E. Commentary: The McKeown debate: time for burial. Int J Epidemiol. 2005 Jun 34(3):529-33. | PubMed |Colgrove J. The McKeown thesis: a historical controversy and its enduring influence. Am J Public Health. 2002 May;92(5):725-9. | PubMed |Link BG, Phelan JC. McKeown and the idea that social conditions are fundamental causes of disease. Am J Public Health. 2002 May;92(5):730-2. | PubMed |McKinlay JB, McKinlay SM. The questionable contribution of medical measures to the decline of mortality in the United States in the twentieth century. Milbank Mem Fund Q Health Soc. 1977 Summer;55(3):405-28. | PubMed |Lalonde M. A new perspective on the health of canadians - A working document. Ottawa, Canada; 1974:1-77. Lalonde M. New perspective on the health of Canadians: 28 years later. Rev Panam Salud Publica. 2002 Sep;12(3):149-52. | PubMed |Gray AM. Inequalities in health. The Black Report: a summary and comment. Int J Health Serv. 1982;12(3):349-80. | PubMed |Marmot M. Social determinants of health inequalities. Lancet. 2005 Mar 19-25;365(9464):1099-104 | PubMed |Irwin A, Valentine N, Brown C, Loewenson R, Solar O, Brown H, et al. The commission on social determinants of health: tackling the social roots of health inequities. PLoS Med. 2006 May;3(6):e106. | PubMed |Lee J, Sadana R. Improving equity in health by addressing social determinants [Internet]. Geneva: World Health Organization. Geneva: World Health Organization; 2011. | Link |Gilson L, Doherty J, Loewenson R, Francis V. Challenging inequity trought heath systems - final report. Knowledge network on health systems. 2007: 1-146. | Link |Commission on Social Determinants of Health. Closing the gap in a generation: health equity trough action on the social determinants of health. Final Report of the Commission on Social Determinants of Health. Geneva: WHO; 2008:1-256. | Link |Solar O, Irwin A. A conceptual framework for action on the social determinants of health. Production. Geneva: WHO; 2010: 1-79. | Link |Frenz P, Vega J. Universal health coverage with equity : what we know, don’t know and need to know. accelerate universal health coverage. Montreux, Zwitzerland:WHO; 2010:1-56. | Link |Marmot M. Universal health coverage and social determinants of health. Lancet. 2013 Oct 12;382(9900):1227-8. | CrossRef | PubMed |Frenz P, Delgado I, Kaufman JS, Harper S. Achieving effective universal health coverage with equity: evidence from Chile. Health Policy Plan. 2014 Sep;29(6):717-31. | CrossRef | PubMed |Navarro V. What we mean by social determinants of health. Glob Health Promot. 2009 Mar;16(1):5-16. | CrossRef | PubMed |Gopinathan U, Cuadrado C, Watts N, Guinto RR, Hougendobler D, Wanjau W, et al. The political origins of health inequity: the perspective of the Youth Commission on Global Governance for Health. Lancet. 2014 Feb 15;383(9917):e12-3. | CrossRef | PubMed |World Health Organization. Declaration of Alma-Ata. Report of the International Conference on Primary Health Care. Geneva:WHO; 1978:1-77. | Link |Rasanathan K, Montesinos EV, Matheson D, Etienne C, Evans T. Primary health care and the social determinants of health: essential and complementary approaches for reducing inequities in health. J Epidemiol Community Health. 2011 Aug;65(8):656-60. | CrossRef | PubMed |Maeseneer M, Willems S, De Sutter M, Van de Geucchte I, Billings M. Primary health care as a strategy for achieving equitable care: a literature review commissioned by the Health Systems Knowledge Network. 2007:1-42. [on line]. | Link |Law I, Widdows H. Health Care Anal. Conceptualising health: insights from the capability approach. 2008 Dec;16(4):303-14. | PubMed |
July 2022, Vol 22, Issue 6
Research papers
Association of biomarkers and severity of COVID-19: A crosssectional study
Systematization of initiatives in sexual and reproductive health about good practices criteria in response to the COVID-19 pandemic in primary health care in Chile
Clinical, psychological, social, and family characterization of suicidal behavior in Chilean adolescents: a multiple correspondence analysis
Systematization of initiatives in sexual and reproductive health about good practices criteria in response to the COVID-19 pandemic in primary health care in Chile
Clinical, psychological, social, and family characterization of suicidal behavior in Chilean adolescents: a multiple correspondence analysis
