Moving Beyond the Social Determinants of Health

Academic interest in the social determinants of health has grown substantially in the past quarter century. In the past decade this academic engagement has been followed by greater public engagement with the conditions where we live, work, and play and how they affect our health. This moment of greater engagement with social determinants presents an opportunity for us to think about the determination of health more broadly, to look to a future beyond the social determinants. This would mean recognizing the full set of determinants of health across the lifecourse, spanning levels of influence, and including medical determinants to cure disease as much as we include the social forces that can prevent, or can cause that disease to begin with. Such a conception would have us see the determination of health as our central concern, and within that to recognize that health is produced throughout the lifecourse, by forces proximal and distal. The scholarship and practice of health can then usefully array itself around a conceptual framing that encompasses the full range of determinants of health.