Different problems, same solutions: Using a social determinants of health approach to work cross-disciplinary and cross-sectorally
Bridging the evidence-policy gap is a recognised challenge for researchers and policy makers alike. In today’s blog post Hannah Badland a Principal Research Fellow at the Centre for Urban Research RMIT University talks about the value of inter-sectoral partnerships to solve complex problems. Using the example of a new global framework, The New Urban Agenda, she discusses how agendas that draw on cross-sectoral collaborations can help advance policy action in complex policy areas such as the social determinants of health.
The social determinants of health are commonly defined as the conditions in which people are born, grow, live, work, and age, and shaped by the distribution of resources, power, and money.[1] Its potential lies as a meaningful framework to anchor cross-discipline collaborations due to definition spanning broad environment domains, including but not limited to, education, employment, housing, transport, social infrastructure, and access to healthy food.[2] The social determinants of health is an important health and well-being lever, given that recent estimates suggest 23% of the global burden of disease is attributable to the environment.[3] Furthermore, the broad nature of the social determinants of health means that it falls within the remit of various sectors with different agendas, presenting opportunities to find mutually beneficial outcomes. Importantly, this includes policy makers who are grappling with major urban challenges, such as delivering affordable housing, fair employment opportunities, and supporting ageing-in-place. The New Urban Agenda is a recent global framework that draws on cross-sectoral collaborations by targeting government, non-government, and private sector to establish key commitments for sustainable and equitable urban development over the next two decades.[4] Action on the social determinants of health have been formalised through the guiding principles of the New Urban Agenda, which through seventeen Sustainable Development Goals, seeks to equitably deliver sustainable urban development through economic prosperity, enhanced well-being, and environmental protection.[4]
To move beyond a framework towards action, the research community needs to pose agendas and questions that are relevant to, and resonate with, the major issues policy makers and practitioners are grappling with. Better still, agendas that are co-developed cross-sectorally and cross-disciplinary from the outset will maximise opportunities for the complexity of the challenges and the system that binds them to be understood and embraced. The value of inter-sectoral partnerships to solve complex problems, such as those related to the social determinants of health, should not be underestimated.[5] Indeed, by working together we can help avoid unintended consequences and create environments that disproportionately benefit the most vulnerable. To reduce inequities, a further opportunity exists for policymakers, practitioners, and researchers to apply an explicit equity lens into practice, and where possible, apply tools at appropriate scales to monitor and track inequities. This aligns closely with the New Urban Agenda’s principle commitment of ‘leaving no one behind’ and is a call to action for all sectors and disciplines on the social determinants of health.
Working towards these goals requires deep and wide knowledge of issues and complexities, with a line of sight to providing evidence that can support coordinated policies and practices that act on the social determinants of health. Applying such a combined approach will likely generate evidence that aligns with, and can better guide and support coordinated policies and practices that act on the social determinants of health to provide good outcomes for all.
References
1. World Health Organization 10 facts on health inequities and their causes. 2017.
2. Badland, H., et al., Urban liveability: Emerging lessons from Australia for exploring the potential for indicators to measure the social determinants of health. Social Science & Medicine, 2014. 111: p. 64-73.
3. Pruss-Ustun, A., et al., Preventing disease through health environments: A global assessment of the burden of disease from environmental risks. 2016, World Health Organization: Geneva.
4. United Nations Sustainable Development Goals: 17 goals to transform our world. 2015.
5. Rayner, J. and M. Howlett, Introduction: Understanding integrated policy strategies and their evolution. Policy and Society, 2009. 28: p. 99-109.
6. World Health Organization, Urbanization and health. Bulletin of the World Health Organization, 2010. 88(4): p. 245-246.
7. WHO 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 of Social Determinants of Health. 2008, World Health Organization: Geneva.
Acknowledgements: Hannah Badland is supported by an RMIT University Vice Chancellor’s Senior Research Fellowship and is the inaugural Australian Health Promotion Association Thinker in Residence.