Social Determinants of Health Initiative
Background: Health disparities have been attributed to many different factors. Since British epidemiologist Sir Michael Marmot first studied British civil servants in the 1970s and found that people in high-status jobs tended to be healthier than those in low-status jobs, socioeconomic factors have been underscored as powerful determinants of health. Marmot has since identified the ten most important social determinants of health: low social status, relentless stress, adversity in early life, social exclusion, stress at work, unemployment, absence of social support, addiction, poor nutrition, and an environment that promotes physical inactivity. Many researchers have since pointed out that health care alone cannot counteract the effects of these factors on health. During the time when the field of health disparities was just burgeoning, a 1995 publication titled Race and Health by Dr. David Williams and Dr. Gary King listed the following factors as the foundation of unequal health outcomes: biological, cultural, socioeconomic, racism, and political. The 2002 publication Unequal Treatment: Confronting Racial and Ethnic Disparities in Healthcare brought attention to the role and importance of broader systems—healthcare, legal, regulatory, policy. Recently, within this spirit of recognizing the relevance and impact of systems, a growing literature in the health disparities field has been referring to the important role of the social determinants of health. This literature clearly states that inequities in health arise because of the circumstances in which people grow, live, work, and age, and the systems put in place to deal with illness. It states that the conditions in which people live and die are, in turn, shaped by political, social, and economic forces. It states that social and economic policies have a determining impact on whether a child can grow and develop to its full potential and live a flourishing life, or whether its life will be blighted. Based on eight years of work and research, the World Health Organization recently completed a final report from its Commission on the Social Determinants of Health. This group had the following overarching recommendations:
- Improve daily living conditions.
- Tackle the inequitable distribution of power, money, and resources.
- Measure and understand the problem and assess the impact of action.
Project Description: Applications for this opportunity would target research developed around the gap area of the social determinants of health with emphasis on health disparities. Research would address one or more of the above recommendations for the two-year grant period. In addition, research would be conducted within a multisystem using a transdisciplinary approach. The multisystem component would encourage that research be done beyond the healthcare system and connect with other sectors, such as education, labor, housing, transportation, or agriculture. The transdisciplinary component would focus on research across disciplines not only within the sciences (basic, clinical, social, health services), but also with disciplines that are not traditionally represented in the healthcare field (e.g., lawyers, teachers, engineers, economists, anthropologists).
How to Apply:
Please refer to RFA-OD-09-004 for application and submission information at
Dr. Kyu Rhee