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What matters for health? Public views from eight countries

Salma M. Abdalla · Mark A. Hernandez · Shaffi Fazaludeen Koya · Samuel B. Rosenberg · Grace Robbins · Laura Magaña-Valladares +3 more

18 citations0/0 files storedBMJ Global Health

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Public Health and Social Inequalities Public Health Policies and Education Health, psychology, and well-being

Abstract

Introduction Despite growing scholarship on the social determinants of health (SDoH), wider action remains in its early stages. Broad public understanding of SDoH can help catalyse such action. This paper aimed to document public perception of what matters for health from countries with broad geographic, cultural, linguistic, population composition, language and income level variation. Methods We conducted an online survey in Brazil, China, Germany, Egypt, India, Indonesia, Nigeria and the USA to assess rankings of what respondents thought matters for health and what they perceived decision makers think matters for health. We analysed the percentages of each determinant rated as the most important for good health using two metrics: the top selection and a composite of the top three selections. We used two-tailed χ2 test for significance testing between groups. Results Of 8753 respondents, 56.2% (95% CI 55.1% to 57.2%) ranked healthcare as the most important determinant of good health using the composite metric. This ranking was consistent across countries except in China where it appeared second. While genetics was cited as the most important determinant by 22.3% (95% CI 21.5% to 23.2%) of the overall sample with comparable rates in most countries, the percentage increased to 33.3% (95% CI 30.5% to 36.3%) in Germany and 35.9% (95% CI 33.0% to 38.8%) in the USA. Politics was the determinant with the greatest absolute difference (18.5%, 95% CI 17.3% to 19.6%) between what respondents considered matters for health versus what they perceived decision makers think matters for health. Conclusion The majority of people consider healthcare the most important determinant of health, well above other social determinants. This highlights the need for more investment in communication efforts around the importance of SDoH.

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2008Closing the gap in a generation: health equity through action on the social determinants of health 2014The Social Determinants of Health: It's Time to Consider the Causes of the Causes 2001Sick individuals and sick populations 2003Social determinants of health: the solid facts 2010Closing the gap in a generation: health equity through action on the social determinants of health. Final report of the Commission on Social Determinants of Health 2017Global action on the social determinants of health 2017Taking stock of the social determinants of health: A scoping review 2014Health in All Policies (HiAP) Framework for Country Action

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