Social Determinants of Health
by Michael Marmot
Social Determinants of Health, 2nd Edition gives an authoritative overview of the social and economic factors which are known to be the most powerful determinants of population health in modern societies. Written by acknowledged experts in each field, it provides accessible summaries of the scientific justification for isolating different aspects of social and economic life as the primary determinants of a population’s health.The new edition takes account of the most recent research and also includes additional chapters on ethnicity and health, sexual behaviours, the elderly, housing and neighbourhoods.Recognition of the power of socioeconomic factors as determinants of health came initially from research on health inequalities. This has led to a view of health as not simply about individual behaviour or exposure to risk, but how the socially and economically structured way of life of a population shapes its health. Thus exercise and accidents are as much about a society’s transport system as about individual decisions; and the nation’s diet involves agriculture, food manufacture,retailing, and personal incomes as much as individual choice. But a major new element in the picture we have developed is the importance of the social, or psycho-social, environment to health. For example, health in the workplace for most employees – certainly for office workers – is less a matter ofexposure to physical health hazards as of the social environment, of how supportive it is, whether people have control over their work, whether their jobs are secure. A similar picture emerges in other areas ranging from the health importance of the emotional environment in early childhood to the need for more socially cohesive communities.Social Determinants of Health should be read by those interested in the wellbeing of modern societies. It is a must for public health professionals, for health promotion specialists, and for people working in the many fields of public policy which we now know make such an important contribution to health.
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