School contexts as social determinants of child health: Current practices and implications for future public health practice

摘要

Public health literature suggests that population health is largely influenced by social determinants of health (SDH), defined as the complex interplay of social and economic systems, including the social and structural conditions in which people are born, grow, live, and work, as well as the systems that are designed to address people's health problems. SDH include, but are not limited to, conditions for early childhood development, education, daily living environments, social networks, health services, and economic and social conditions of communities. SDH are shaped by the level of income, power, and resources available at global, national, and local levels. Research suggests that SDH are responsible for most national and global health disparities and inequities, commonly represented at higher incidence, prevalence, and burden of health problems in certain geographic regions and among racial/ethnic, socioeconomic, or gender groups. The application of SDH to address health disparities in the United States is a relatively new approach that emerged in the early 2000s. However, most of this work has focused on adults, with very little attention directed toward children. Because health disparities often take root in early childhood and persist over time, addressing health disparities and inequities though SDH must begin in childhood.