A look at the history of science over the last century reveals an explosion of progress across numerous fields. In physics, we’ve explored relativity; in medicine, groundbreaking discoveries have emerged in areas such as DNA, germ theory, imaging, and vaccine development. Advances in communication—including radio, television, and the internet—along with progress in computers, space exploration, genetics, and biotechnology, have profoundly transformed our lives. As we continue to innovate, these advancements will undoubtedly shape our future in remarkable ways.
In healthcare, scientists have devoted years to understanding what it means to be human and how we can live longer, healthier lives. They have examined minute samples, such as tiny drops of blood or individual cells, to investigate our biology at the molecular level. This work has revealed that we are composed of molecules, and the chemical and physical reactions among these molecules sustain our life and functionality. When these reactions become disordered, we can become ill or even face death. As a result, scientists have developed various interventions to prevent, correct, or reverse these disorders.
However, a critical oversight in focusing solely on molecular biology is the neglect of the broader context of human existence. How can we ignore the impact of our environment and social context on our health? Clearly, my well-being depends on far more than just the chemical reactions occurring within my body.
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The microscopic cells studied in laboratories can originate from individuals living in vastly different circumstances—whether in wealth or poverty, at the center of society or on its margins, and from positions of privilege or disadvantage. It is crucial to understand that these social contexts influence health outcomes as much, if not more than, the biological processes we have long emphasized.
If health is the ultimate goal of humanity and a foundation for economic stability, it is essential to examine what truly influences our health. This is where the concept of Social Determinants of Health (SDoH) comes into play. SDoH offers a comprehensive view of the factors that affect our health, recognizing that the conditions in which we live, work, learn, and interact profoundly impact our well-being.
While the biomedical model has provided valuable insights into health and disease, it is time to broaden our perspective. By embracing Social Determinants of Health, we can achieve a more holistic understanding of what truly keeps us healthy and strive toward a future where all individuals have the opportunity to thrive.
SDoH is not a new concept; it has been recognized for decades. In 1941, C. E. A. Winslow, President of the American Public Health Association, wrote “
, “Thirty years ago, our major emphasis was transferred from the physical environment to the individual. Today, we must shift our gaze from the individual back to the environment, but in a broader sense… to the whole social and economic environment in which the individual lives and moves and has his being.”
However, it was Sir Michael Marmot, a Professor of Epidemiology and Public Health at University College London, who brought significant attention to this topic through his influential works and his landmark report Closing the gap in a generation , for the World Health Organization in 2008. This report has had broad policy implications, influencing government policies across various sectors, including economics, education, health, and the environment.
Many health professional organizations and educational institutions have since incorporated SDoH into their policies and curricula. Understanding SDoH has significant implications for how we educate the next generation of healthcare professionals, how we provide care, and how we structure payment systems for health services.
In conclusion, as we become more interconnected due to technology and globalization, embracing the Social Determinants of Health is essential for a comprehensive understanding of health and well-being. By recognizing the interplay between biology and social context, we can work toward a healthier future for all.
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