Integrating Social Determinants in Decision-Making Processes for Health: Insights from Conceptual Frameworks-the 3-D Commission.

Diogo Correia Martins, Opeyemi Babajide, Nason Maani, Salma M Abdalla, Eduardo J Gómez, Montira J Pongsiri, Sheila Tlou, Gabriel Matthew Leung, Georges C Benjamin, Eric Goosby, Katie Dain, Jeanette Vega, Zahra Zeinali, Preslava Stoeva, Sandro Galea, Jeffrey Sturchio, Nana A Y Twum-Danso
Author Information
  1. Diogo Correia Martins: London School of Hygiene & Tropical Medicine (LSHTM), London, UK.
  2. Opeyemi Babajide: Rockefeller Foundation-Boston University 3-D Commission on Determinants, Data, and Decision-making, Boston, USA.
  3. Nason Maani: Rockefeller Foundation-Boston University 3-D Commission on Determinants, Data, and Decision-making, Boston, USA.
  4. Salma M Abdalla: Rockefeller Foundation-Boston University 3-D Commission on Determinants, Data, and Decision-making, Boston, USA. abdallas@bu.edu.
  5. Eduardo J Gómez: Rockefeller Foundation-Boston University 3-D Commission on Determinants, Data, and Decision-making, Boston, USA.
  6. Montira J Pongsiri: Rockefeller Foundation-Boston University 3-D Commission on Determinants, Data, and Decision-making, Boston, USA.
  7. Sheila Tlou: Rockefeller Foundation-Boston University 3-D Commission on Determinants, Data, and Decision-making, Boston, USA.
  8. Gabriel Matthew Leung: Rockefeller Foundation-Boston University 3-D Commission on Determinants, Data, and Decision-making, Boston, USA.
  9. Georges C Benjamin: Rockefeller Foundation-Boston University 3-D Commission on Determinants, Data, and Decision-making, Boston, USA.
  10. Eric Goosby: Rockefeller Foundation-Boston University 3-D Commission on Determinants, Data, and Decision-making, Boston, USA.
  11. Katie Dain: Rockefeller Foundation-Boston University 3-D Commission on Determinants, Data, and Decision-making, Boston, USA.
  12. Jeanette Vega: Rockefeller Foundation-Boston University 3-D Commission on Determinants, Data, and Decision-making, Boston, USA.
  13. Zahra Zeinali: Rockefeller Foundation-Boston University 3-D Commission on Determinants, Data, and Decision-making, Boston, USA.
  14. Preslava Stoeva: London School of Hygiene & Tropical Medicine (LSHTM), London, UK.
  15. Sandro Galea: Rockefeller Foundation-Boston University 3-D Commission on Determinants, Data, and Decision-making, Boston, USA.
  16. Jeffrey Sturchio: Rockefeller Foundation-Boston University 3-D Commission on Determinants, Data, and Decision-making, Boston, USA.
  17. Nana A Y Twum-Danso: Rockefeller Foundation-Boston University 3-D Commission on Determinants, Data, and Decision-making, Boston, USA.

Abstract

The inclusion of social determinants of health offers a more comprehensive lens to fully appreciate and effectively address health. However, decision-makers across sectors still struggle to appropriately recognise and act upon these determinants, as illustrated by the ongoing COVID-19 pandemic. Consequently, improving the health of populations remains challenging. This paper seeks to draw insights from the literature to better understand decision-making processes affecting health and the potential to integrate data on social determinants. We summarised commonly cited conceptual approaches across all stages of the policy process, from agenda-setting to evaluation. Nine conceptual approaches were identified, including two frameworks, two models and five theories. From across the selected literature, it became clear that the context, the actors and the type of the health issue are critical variables in decision-making for health, a process that by nature is a dynamic and adaptable one. The majority of these conceptual approaches implicitly suggest a possible role for data on social determinants of health in decision-making. We suggest two main avenues to make the link more explicit: the use of data in giving health problems the appropriate visibility and credibility they require and the use of social determinants of health as a broader framing to more effectively attract the attention of a diverse group of decision-makers with the power to allocate resources. Social determinants of health present opportunities for decision-making, which can target modifiable factors influencing health-i.e. interventions to improve or reduce risks to population health. Future work is needed to build on this review and propose an improved, people-centred and evidence-informed decision-making tool that strongly and explicitly integrates data on social determinants of health.

Keywords

References

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MeSH Term

COVID-19
Health Policy
Humans
Pandemics
SARS-CoV-2
Social Determinants of Health

Word Cloud

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