The right to sutures: social epidemiology, human rights, and social justice

Abstract

The article examines the convergences and contrasts between social epidemiology, social medicine, and human rights approaches toward advancing global health and health equity. The first section describes the goals and work of the WHO Commission on Social Determinants of Health. The second section discusses the role of human rights in the Commission's work. The third section evaluates, from the perspective of social epidemiology, two rights-based approaches to advancing health and health equity as compared to a view that focuses more broadly on social justice. The concluding section identifies four areas where social epidemiologists, practitioners of social medicine, and health and human rights advocates can and must work together in order to make progress on health and health equity.

Figure 1

Commission on Social Determinants of Health conceptual framework Source: Commission on Social Determinants of Health, Closing the gap in a generation: Health equity through action on the social determinants of health. Final Report of the Commission on Social Determinants of Health (Geneva: World Health Organization, 2008), p. 43. Available at http://whqlibdoc.who.int/publications/2008/9789241563703_eng.pdf. Amended from O. Solar and A. Irwin, “A conceptual framework for action on the social determinants of health,” in Discussion paper for the Commission on Social Determinants of Health (Geneva: World Health Organization, 2007). Available at http://www.who.int/social_determinants/resources/csdh_framework_action_05_07.pdf. Reprinted with permission.

Figure 2

Under-5 mortality rate per 1000 live births by level of household wealth. Source: Commission on Social Determinants of Health, Closing the gap in a generation: health equity through action on the social determinants of health. Final Report of the Commission on Social Determinants of Health (Geneva: World Health Organization, 2008), p. 30, using DHS data adapted from D. R. Gwatkin, S. Rutstein, K. Johnson, et al., Socio-economic differences in health, nutrition, and population within developing countries: An overview, Country Reports on HNP and Poverty (Washington: World Bank, 2007). Reprinted with permission.