Department of Public Health Sciences, Stockholm University, Sweden.
Scand J Public Health. 2020 Jul;48(5):473-479. doi: 10.1177/1403494819894789. Epub 2020 Feb 3.
During the past 15-20 years the Social Determinants of Health (SDoH) framework has become the main approach to understand health inequalities. With this model a range of factors important for health and inequalities in health over the life-course have been connected into a larger framework. Despite its usefulness and popularity within the field, and wide use in influential reviews, the SDoH framework has not been easy to communicate to stakeholders in other sectors, and we cannot as yet see much of substantial societal change as a result of it. In this Commentary I try to discuss possible reasons behind our difficulties to communicate the SDoH perspective. Some of these reasons relate to how we frame and present the different parts of the framework, others are more linked to common beliefs and practices that I think we should rethink. In both cases, I believe that we would benefit from a more general discussion around these fundamental issues, both in order to communicate our important insights but also to better understand our own key study objective, namely how health inequalities are generated, sustained and potentially reduced.
在过去的 15-20 年中，健康的社会决定因素（SDoH）框架已成为理解健康不平等现象的主要方法。通过该模型，一系列对健康和整个生命过程中的健康不平等至关重要的因素已被纳入一个更大的框架中。尽管该框架在该领域内具有实用性和知名度，并且在有影响力的评论中得到了广泛应用，但要将其传达给其他部门的利益相关者并不容易，而且我们目前还没有看到它带来实质性的社会变革。在这篇评论中，我试图讨论我们在传达 SDoH 观点方面遇到困难的可能原因。其中一些原因与我们构建和呈现框架的不同部分有关，而另一些原因则与我认为我们应该重新思考的一些常见信念和实践更为相关。在这两种情况下，我认为我们都将受益于围绕这些基本问题进行更广泛的讨论，以便不仅传达我们的重要见解，而且更好地理解我们自己的主要研究目标，即健康不平等现象是如何产生、维持和潜在减少的。
