Literature review


Evidence review: Settings for addressing the social determinants of health inequities

1 Sep 2015

This report provides an overview of the evidence base on work in health promotion settings that addresses the social determinants of health inequities. The review identifies key aspects of ‘what works’ to reduce health inequities in settings through focussing on social determinants of health. It also provides recommendations for future planning, action and research. We note that while we identified much health promotion activity in settings, only a fraction of this addresses one or more social determinants of health. Furthermore, even where settings-based approaches are addressing social determinants, most work reports only on population outcomes and there is a distinct lack of studies which explicitly evaluate the impact on health equity. Making the everyday settings of people’s lives – where they live, love, play, work and google – more supportive of healthy choices has long been recognised by health promoters as an optimum way to improve population health. The World Health Organisation's Ottawa Charter (1986) recognises that health is created and lived by people within these settings and that policies and institutional practices shape the opportunities people have to lead healthy lives and make healthy choices. Addressing social determinants within settings is particularly relevant following three major reports which identify this as the most significant way to improve health equity. These are Closing The Gap in A Generation: Health Equity Through Action on the Social Determinants of Health (Commission on the Social Determinants of Health, CSDH 2008); Fair Society, Healthy Lives (The Marmot Review): Strategic Review of Health Inequalities in England Post 2010 (Marmot et al, 2010) and the WHO European Review of Social Determinants of Health & the Health Divide (Marmot et al 2012).

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