Final Report: Regional Consultation on the Work of the Commission on Social Determinants of Health

The Pan American Health Organization (PAHO) and the World Health Organization (WHO) held a joint regional consultation for the Americas, bringing together 13 countries to support the work of the Commission on Social Determinants (CSDH), established by the WHO in March of 2005. This document summarises their efforts to strengthen public policies, disseminate information from issues-based scientific networks, and consult with civil society organisations in the region on how to contribute to actions on social determinants.

During the consultation, a number of member countries including Brazil, Mexico, Guatemala, the United States and Canada presented information on programmes designed to alleviate health care inequities. These programmes attempted to approach the PAHO goal of equitable and universal access to health care. The commonalities and diversities of the cases were analysed. Social determinants included exclusionary factors, health budget allocations, priority setting, sustainability, resources, and assessments, with the following recommendations for the CSDH:

• Give explicit attention to themes of ethnicity and gender.
• Broaden focus on early intervention in health rather than vertical disease programmes.
• Focus on social factors that influence health such as violence prevention or addiction prevention.
• Adopt the concept of human security as part of a triad along with environmental and economic sustainability.

Contributors to the panel on "Technical Cooperation" addressed inequities in their thematic areas including, gender, sustainability, and social exclusion, among others, and present issues and evidence supporting PAHO's efforts and demonstrating areas of strategic need. The panel on "Knowledge Network" addressed aspects of information and knowledge management.

The final panel discussed the opportunities for member states and the PAHO/WHO Secretariat to advance the work of the CSDH in three broad spheres: political, scientific, and social. Work in the political sphere is aimed to create, inform, and strengthen public policies and practices. In the scientific sphere, the focus is the creation of networks of experts
for selected issues including:

• early child development;
• globalisation;
• the urban environment;
• health systems;
• priority public health conditions; and
• labour conditions.

Finally, the work in the social sphere is consultation on social determinants with civil society groups in order to remove barriers and find ways for these groups to take action steps toward health solutions.