Social Determinants of Health Revisited: Detouring Around the Weberian Bureaucracy

The knowledge of the Social Determinants of Health (SDH) approach implies Health in All Policies and thorough cultural and social transformations, as well as whole-of-government, whole-of-society policies and governance to address health inequities. Nonetheless, this article argues that in the currently dominant rational decision-making model in health policymaking, these policy implications from the knowledge of the SDH approach would lead to an intrinsic contradiction with the logic of modern bureaucracy based on the legal authority as suggested by Max Weber. Using two examples of social determinants of health - universal health coverage and housing issues - this article demonstrates the potential of the polis model proposed by Deborah Stone to take advantage of the knowledge of the SDH approach to pursue structural policy interventions.