Tracking the progress of social determinants of health

1800s

The founders of modern public health stress the correlation between a person’s social position and her or his health outcomes.

1945

The United Nations Conference on International Organization suggests creating a global health organization.

1948

The World Health Organization kicks off with a constitution that defines health as “a state of complete physical, mental and social well-being.” The group will promote “the improvement of nutrition, housing, sanitation, recreation, economic or working conditions and other aspects of environmental hygiene,” to achieve optimal health.

1957

Two Democratic congressmen propose a national health insurance program for older Americans because so many seniors have chronic health conditions and can’t afford the cost of hospitalization. This led to the creation of Medicare in 1965.

1960s and ’70s

Community organizers in developing countries such as India, Mexico and the Philippines work to promote social and environmental determinants of health and mobilize to take on political and economic issues.

1962

Michael Harrington’s book The Other America demonstrated that poverty was far more widespread than commonly assumed. It spurred Presidents John F. Kennedy and Lyndon B. Johnson to formulate an anti-poverty agenda, which led to Johnson’s War on Poverty. As a result, Congress created Medicare and Medicaid; expanded Social Security benefits; passed the Food Stamp Act; and established the Job Corps, Head Start and other anti-poverty programs.

1976

Danish public health advocate Dr. Halfdan Mahler becomes director-general of the WHO and proposes “Health for All” by the year 2000.

1978

3,000 delegates from 134 governments and 67 global organizations participate in the AlmaAta conference, which was sponsored by the WHO and UNICEF, promoting primary healthcare as the ideal model.

1985

The Rockefeller Foundation hosts the Good Health at Low Cost Conference.

1997

The British government releases the Acheson Report, which recommends considering the impact on health equity of all government policies.

1990s

Efforts are made worldwide to improve maternal and pediatric health and combat HIV/AIDS rates by focusing on preventive care and education.

2002

Sweden creates a national strategy that sets public health objectives that take into account a person’s ability to thrive economically. Even today, it’s considered the most comprehensive national policy on social determinants of health.

2010

HHS launches Healthy People 2020, a 10-year agenda for improving the nation’s health.

2010

Congress passes the Patient Protection and Affordable Care Act to promote overall public health, recognizing the health disparities associated with people not having health coverage due to low incomes and/or pre-existing medical conditions. The law established a $10 billion Prevention and Public Health Fund to expand national investments in prevention and public health and improve health outcomes.

2015

Prominent economists Anne Case and Angus Deaton publish the paper “Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century,” which highlights the rising all-cause mortality rate among middle-aged white Americans in the previous decade.