Community Health Journal

Community Health Journal

Social Determinants of Health: The Foundation for Achieving Health Equity

Editor-in-Chief Lecture

Author
Professor, Department of Medical Surgical Nursing, Faculty of Nursing and Midwifery, Non-Communicatable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
10.22123/chj.2026.595239.2295
Abstract
Social Determinants of Health: The Foundation for Achieving Health Equity
Health is the foundation of sustainable development and one of the most important indicators of societal well-being. Despite remarkable advancements in medicine and technology, health inequalities persist; this is because health is not shaped solely within healthcare facilities but is influenced, above all, by the conditions in which individuals are born, grow, live, work, and age. Today, the social determinants of health are considered a central focus of health system policymaking, and achieving health equity is impossible without addressing these factors. Evidence from recent years indicates that factors such as poverty, education, employment, housing, food security, the environment, social capital, and equitable access to services play a far greater role in shaping community health than medical services do [1-2].
The COVID-19 pandemic has once again demonstrated that individual vulnerability is not limited to biological factors alone; rather, socioeconomic inequalities can exacerbate the consequences of health crises [3]. Despite this evidence, health policies in many countries—including Iran—continue to prioritize treatment over the prevention and remediation of the social determinants of health. Reducing health inequalities requires intersectoral collaboration and the implementation of the "Health in All Policies" approach—a framework that views health as a shared responsibility across all development sectors, ranging from education and the economy to urban planning, the environment, and social welfare [4].
Keywords

 
 
1.        World Health Organization. World report on social determinants of health equity. Geneva: World Health Organization; 2025. https://www.who.int/teams/social-determinants-of-health/equity-and-health/world-report-on-social-determinants-of-health-equity.
2.        Marmot M, Allen J, Bell R, Bloomer E, Goldblatt P. WHO European review of social determinants of health and the health divide. Lancet. 2012;380(9846):1011-29.
3.        Marmot M, Allen J. COVID-19: exposing and amplifying inequalities. J Epidemiol Community Health. 2020;74(9):681-2.
4.        World Health Organization. Health in All Policies (HiAP): Framework for Country Action. Geneva: World Health Organization; 2014. https://www.afro.who.int/sites/default/files/2017-06/140120HPRHiAPFramework.
5.        World Health Organization. Global research agenda on knowledge translation and evidence-informed policy-making for health. Geneva: World Health Organization; 2023. https://www.who.int/publications/i/item/9789240118867.