Social determinants of Health’s universe. Third part. Marcio Ulises Estrada Paneque. MD. PhD.* Genco Estrada Vinajera. MD.** Caridad Vinajera Torres. PhD.***. Some questions. Why the equity and social justice in health constitute ethical guides to build bases and suggest public policies?
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Marcio Ulises Estrada Paneque. MD. PhD.*
Genco Estrada Vinajera. MD.**
Caridad Vinajera Torres. PhD.***
Different analyses around SDH identifies three main boardings, with complementary contributions (Solar & Irwin, 2007):
All of them look explain health inequities. Although don’t leave from disease social distribution analysis, its interpretation is not reduced to biological aspects that are integrated to social explanations with different emphases in the prospect of population health
It does not deny psycho-social consequences of inequity in the income, but argue the necessity of begin from the inequity structural causes.
- Social selection, where health determines socioeconomic position and not the inverse process. Health exerts an important influence in the profit of social positions as a result of the social mobility, through which the healthy ones are in better conditions for ascending than those that suffer diseases or incapacities.
• A strategic frame to act on the SHD adopts a concept of social position like central concept to interpret health inequities mechanisms, that generate power distribution, wealth and risks.
- Structural determinants, defined by the social stratification and its mechanisms of maintenance.
- Intermediaries determinants, regarding factors and specific social circumstances.
To reduce the inequities in health entails: