Journal of
Public Health and Epidemiology

  • Abbreviation: J. Public Health Epidemiol.
  • Language: English
  • ISSN: 2141-2316
  • DOI: 10.5897/JPHE
  • Start Year: 2009
  • Published Articles: 569

Full Length Research Paper

Social determinants of health: Conceptual and operational predicaments

Rajan R. Patil
School of Public Health, SRM University, Chennai, India.
Email: [email protected]

  •  Accepted: 12 November 2012
  •  Published: 31 January 2013


Health is determined by many factors ranging from one’s immediate physical-psycho-socio environment to the political milieu of the society that an individual lives in. When we look through the biomedical paradigm of health, disease could be explained through a set of micro-level physiological, bio-chemical and pathological changes in the body which are triggered by internal or external environment. When we broaden the horizon and contextualize health through social medicine paradigm, the whole gamut of constellation of macro level determinants also known as social determinants of health come to the fore. The Social determinants are generally outside the realm of individual control for example, the politics, policies, International agreements like General Agreement on Tariffs and Trade (GATTS), Trade-Related Aspects of Intellectual Property Rights (TRIPS), KYOTO protocol etc affect health so also national upheavals like civil wars, communalism, fundamentalism within the country, all of which effect health. This paper tries to drive home the point that while all determinants of health have their own importance, however it is important that we prioritize determinants as actionable and explanatory determinants. Actionable determinants are those predictors of health that easily lend themselves to direct action. Explanatory determinants are factors or philosophies or models that help us in further understanding health as theoretical construct. Innovative efforts need to be made to convert more and more explanatory health determinants into the ambit of actionable health determinants to evolve innovative interventions to demonstrate that action on social determinants of health is feasible.


Key words: Social determinants, causation, risk factor.