The well-being of a population cannot only to be achieved by treating illnesses. Other range of factors such as people’s social, cultural and economic environments plays a significant role in their health and it cannot be ignored. On October 19th WHO is convening the World Conference on Social Determinants of Health in Rio de Janerio. The aim of the conference is to foster dialogue among Member States and stakeholders on policies and strategies aimed at reducing health inequalities. The event is also meant to engage Member States on strategizing on how recommendations of the WHO Commission of Social Determinants of Health (2008) could be taken forward. According to the commission, “the marked health inequities between countries are caused by the unequal distribution of power, income, goods, and services, globally and nationally, the consequent unfairness in the immediate, visible circumstances of peoples’ lives – their access to health care, schools, and education, their conditions of work and leisure, their homes, communities, towns, or cities – and their chances of leading a flourishing life.” The Commission’s overarching recommendations are:
- Improve daily living conditions
- Tackle the inequitable distribution of power, money and resources
- Measure and Understand the Problem and Assess the Impact of the Action
The Brazilian government has shown stewardship in beginning to address social detriments in improving its peoples’ lives. Even prior to offering to host this conference, the Brazilian government has endorsed health care practitioners decades ago that understood the correlation between socioeconomic conditions and health such as Vera Corderio. Corderio, a physician at Hospital du Lagoa, a public hospital in Rio founded Associação Saúde Criança Renascer in 1991. She could not bear to see the hospital discharge children into the same conditions that produced their diseases. They were often readmitted to the hospital only few weeks later. As a response to this vicious cycle, Renascer’s objective is to help mothers of vulnerable children learn how to prevent recurrences of illnesses and minimize crises.
Renascer employs doctors, nurses and social workers to identify poor children before they are discharged from the hospital. The families are encouraged to work with Renascer by being offered incentives such as free nutritional supplements and medicine for six months. In exchange for these incentives the families work with Renascer team in designing treatments plans and setting specific, time-bound goals. The goals range from fixing a roof to acquiring the documentation to be eligible for government assistance. By addressing these underlying social detriments, the risk of child’s readmission is reduced and the mothers adopt healthier habits. Due to the success of the program and the financial support of Ashoka and the Brazilian government, this model has been replicated to sixteen public hospitals throughout Brazil. Corderio and the Brazilian government are examples that regardless whether our approach is bottom-up or top-down, addressing social detriments to health are key to ensuring the long-term well-being of our society.