The social determinants of health and health disparities /

Braveman (Univ. of California, San Francisco) provides an important introduction to social determinants of health (SDOH) for students, faculty, and administrators. A leader in SDOH thought, she elucidates the history of the development of the pertinent theories, their application to the current state of health, and prognostic thinking about interventions aimed at narrowing health inequities/disparities. The author reviews how income, education, stress, racism, early childhood experiences, the built environment, work, and behaviors all influence health. In doing so, she analyzes both the factors themselves and their pathways to influencing health and either narrowing or enlarging health inequities. Braveman frames SDOH within an upstream (systemic) and downstream (individual) discourse, while citing alternative views, e.g., Nancy Krieger's system of pathways, levels, and power. Krieger's ecosocial theory explicitly situates power and its distribution as driving health inequities, and while not mentioning capitalism references it and contends that thinking about space, time, and level is ultimately more useful than a proximal/distal or upstream/downstream framework. A missing dimension of Braveman's analysis is that of colonialism and history (here one thinks of countries such as India or entire regions such as Africa or Oceania, and the experience of people who were enslaved). Given these caveats, however, this volume is an outstanding introduction to SDOH. Summing Up: Highly recommended. Upper-division undergraduates. Graduate students, faculty, and professionals. --Kawika Liu, Imperial Health Holdings Inc.