1. Addressing social determinants of health in the context of sustainable human development Prof Sir Michael Marmot www.instituteofhealthequity.org @MichaelMarmot @TheMarmotReview Commonwealth Economic and Social Development staff meeting 29 th June 2016 February 2015

2. The WHO Commission on Social Determinants of Health (CSDH) – Closing the gap in a generation Improve the conditions in which people are born, grow, live, work, and age Tackle the Inequitable Distribution of Power, Money, and Resources Measure and Understand the Problem, Evaluate Action, Expand the Knowledge Base, Develop the Work Force

3. Socioeconomic and political context Governance Policy Macroeconomic Social Health Cultural and societal norms and values Education Occupation Income Gender Ethnicity / Race Social position Material circumstances Social cohesion Psychosocial factors Behaviors Biological factors Health care system Distribution of health and well-being Social determinants of health and health inequities Commission on Social Determinants of Health Conceptual Framework Source: CSDH Final Report, WHO 2008

5. The relationship between wealth and health,2012 Source: Data from Gapminder

6. Source: Data from DHS

7. Under five mortality per 1000 live births by mother’s education: Peru 2000 and 2012 (U5M for the ten years preceding the survey)Source: measuredhs.com

9. A.Give every child the best start in life B.Enable all children, young people and adults to maximise their capabilities and have control over their lives C.Create fair employment and good work for all D.Ensure healthy standard of living for all E.Create and develop healthy and sustainable places and communities F. Strengthen the role and impact of ill health prevention Marmot Review: 6 Policy Objectives

10. Adverse Childhood Experiences: England Bellis et al., 2014

11. Prevalence rates of intimate partner violence

12. Domestic Violence is a Public Health Issue 35% of women suffer from it. 42% of these women experience injuries. 38% of all murdered women are murdered by partners (6% of all murdered men) Source: WHO Global and regional estimates of violence against women, 2013

14. Transnational context: Economic Issues Sustainability and environment

15. Average numeracy score by parent educational background (PEB) and inequality OECD Focus on inequality and growth, 2014

16. How will the SDG’s promote health equity? Measurement and monitoring is key Practical choice of indicators dependent on: Context No data no problem! - Availability of data sources Disaggregate existing data sources by dimensions of inequity

17. Bangladesh: Trends in child* mortality by gender of child and years of education of household head Adams et al, Lancet 2013 ( * ages 1-5)

18. Bringing Development and Health Together Bell, Grobicki & Hamelmann, IHE/UNDP 2014

19. Michael Marmot Health is a human right Do something Do more Do better