Abstract

There is overwhelming evidence that social factors have profound influences on health. Children are particularly sensitive to social determinants, especially in the early years. Life course models view health as a developmental process, the product of multiple gene and environment interactions. Adverse early social exposures become programmed into biological systems, setting off chains of risk that can result in chronic illness in mid-life and beyond. Positive health-promoting influences can set in motion a more virtuous and health-affirming cycle, leading to more optimal health trajectories.
Mounting an effective response to social determinants will involve both direct social policy initiatives designed to eliminate poverty and inequality, and indirect approaches focused on disrupting pathways between social risks and poor health outcomes. To be effective, these indirect strategies will require nothing short of a transformation of existing child health systems. Parents and professionals must work together from the ground up, raising public awareness about social determinants of health and implementing cross-sector place-based initiatives designed to promote positive health in childhood.
The social determinants of health are composed of the conditions in which people are born, grow up, live, work and age, together with the systems that are put in place to deal with illness (World Health Organization [WHO] 2008). The distribution of money, power and resources within society, influenced at least in part by policy choices, economics and politics, shape these conditions at local, regional and national levels. Social determinants operate at individual as well as population levels, influencing the extent to which each person possesses the physical, social and personal resources to identify and achieve personal goals, satisfy needs of daily living and cope with the environment (Raphael 2008)./.../