2024/02/16 by JONATHAN C. HELLER, Jonathan Heller, Marjory L. Givens +5 · 1 citation
Business, Management and Accounting · Health Professions · Social Sciences · #Global Public Health Policies and Epidemiology #Health disparities and outcomes #Public Health Policies and Education
paper · pdf · doi:10.1111/1468-0009.12695
openalex publication_date 2024/02/16 · openalex created_date 2025/10/10 · openalex updated_date 2026/08/01
Policy Points The structural determinants of health are 1) the written and unwritten rules that create, maintain, or eliminate durable and hierarchical patterns of advantage among socially constructed groups in the conditions that affect health, and 2) the manifestation of power relations in that people and groups with more power based on current social structures work-implicitly and explicitly-to maintain their advantage by reinforcing or modifying these rules. This theoretically grounded definition of structural determinants can support a shared analysis of the root causes of health inequities and an embrace of public health's role in shifting power relations and engaging politically, especially in its policy work. Shifting the balance of power relations between socially constructed groups differentiates interventions in the structural determinants of health from those in the social determinants of health.