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Research Papers

The integration of evidence from the Commission on Social Determinants of Health in the field of health equity: a scoping review

ORCID Icon, ORCID Icon, ORCID Icon & ORCID Icon
Pages 415-428 | Received 07 Dec 2017, Accepted 06 Oct 2018, Published online: 05 Dec 2018
 

ABSTRACT

In 2008, the World Health Organization’s Commission on Social Determinants of Health (CSDH) presented an influential compilation of evidence establishing the relationship between health inequities and the unfair distribution of power, wealth, and resources. A decade later, individual and bio-behavioural responses to health inequities persist. The purpose of this scoping review was to explore the extent to which this evidence guided research, practice, and policy in global and public health. To do this, we assessed different ways the CSDH evidence and calls for action were integrated in scholarly publications (citation, portrayal of health inequities, alignment with calls for action, and orientation toward root causes). A systematic search of peer-reviewed articles (2000–2016) using search terms related to ‘knowledge-to-action’ and ‘health equity’ led to 330 included articles. Results suggest integration of CSDH evidence and calls for action in scholarly work is modest: 59% (n = 163) of authors (2009–2016) cited the report. A large portion of authors did not reference causes of health inequities (52% before and 51% after the CSDH) and few referred to issues of power. Among 110 post-CSDH empirical articles, half did not align with CSDH principles for action. This review illustrates that much scholarly work that purported to contribute to health equity did so in ways that conflicted with the CSDH’s characterization of the remediable nature and distribution of health inequities. These results provide a practical platform for assessing how global and public health efforts can move towards better alignment with the best available evidence about advancing health equity.

Acknowledgements

The authors gratefully acknowledge the thoughtful feedback of Dr Michael Burgess, whose attentive reading and comments strengthened our arguments.

Disclosure statement

No potential conflict of interest was reported by the authors.

Supplementary materials

Supplemental data can be accessed here

Notes

1. The executive summary for the CSDH Report was published in ten languages, and the full report in seven.

2. A complete listing of articles included in this review are available from the corresponding author upon request.

3. Scholars who challenge the status quo can find themselves at significant risk both professionally and personally. For more on this, see for example, the Scholars at Risk Network (https://www.scholarsatrisk.org).

Additional information

Funding

As part of KMPs doctoral dissertation, this study was supported by a Canadian Institutes for Health Research Doctoral Award-Frederick Banting and Charles Best Canada Graduate Scholarship, Competition 201310GSD (FRN: 134843).

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