Social determinants of health: A challenge for decision-making ethics in health policy

Abstract

According to the social determinants of health approach, the health of populations, and the health inequalities that prevail within them, are to a large extent influenced by social factors, modifiable by public policies, which are located well upstream of these health conditions. It would follow from this that public policies favorable to health should intervene at this causally fundamental level. However, the undeniable presence of social determinants does not imply that we fully understand the precise mechanisms by which these determinants become the vehicles of health states. Research on determinants yields at best probabilistic results. Since health is a good against which public decision-makers must guard against risk and uncertainty