Director of Knowledge Exchange and Research Impact, Usher Institute, University of Edinburgh, Room 1-308, Doorway #1, Teviot Hall, Teviot Place, Edinburgh EH8 9AG, UK.
ISPM, University of Bern, 3012 Bern, Switzerland.
Int J Environ Res Public Health. 2020 Aug 12;17(16):5856. doi: 10.3390/ijerph17165856.
Twelve years have now passed since the influential WHO Report on the Social Determinants of Health (SDoH) in 2008. A group of senior international public health scholars and decision-makers met in Italy in mid-2019 to review the legacy of the SDoH conceptual framework and its adequacy for the many challenges facing our field as we enter the 2020s. Four major categories of challenges were identified: emerging "exogenous" challenges to global health equity, challenges related to weak policy and practice implementation, more fundamental challenges related to SDoH theory and research, and broader issues around modern research in general. Each of these categories is discussed, and potential solutions offered. We conclude that although the SDoH framework is still a worthy core platform for public health research, policy, and practice, the time is ripe for significant evolution.
自 2008 年世界卫生组织（WHO）发布具有影响力的《社会决定因素健康报告》以来，十二年已经过去。一群资深的国际公共卫生学者和决策者于 2019 年年中在意大利会面，回顾了 SDoH 概念框架的影响及其在我们进入 21 世纪 20 年代后面临的诸多挑战中的适应性。会议确定了四大类挑战：新兴的全球健康公平“外生”挑战、与政策和实践执行乏力相关的挑战、与 SDoH 理论和研究相关的更根本挑战，以及更广泛的现代研究相关问题。每一类挑战都进行了讨论，并提出了潜在的解决方案。我们的结论是，尽管 SDoH 框架仍然是公共卫生研究、政策和实践的一个有价值的核心平台，但现在是进行重大变革的成熟时机。
