Inequalities: social determinants & the environment

Many of the key risk factors significant to the development of chronic disease follow the social gradient: smoking, obesity, lack of physical activity and poor nutrition.  The environment both built and natural, is also a major determinant of health.  Inequalities in health stemming from social and environmental determinants are avoidable and preventable.  Reductions in the social gradient would lead to deaths avoided and increased healthy life expectancy.

Social determinants:

- The burden of disease falls disproportionately on people living in deprived conditions.  For some populations and ethnic groups, there is an increased burden of particular chronic conditions.

- Opportunities for decent education, steady employment and policies to protect men and women in the workplace are also factors that affect health.

- Access to universal healthcare and social protection through life can prevent ill-health and poverty for millions of people. 

The environment:

Environmental risk factors include pollution, injuries and climate change. The places in which we live, work and play affect our health and our chances of living flourishing lives. Built environment determinants include safe and accessible public transport; access to healthy and affordable foods; and well-lit and clean green space.

Health Inequalities in England were comprehensively investigated and described in the Marmot Review in 2010.

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