Broadening the Focus: The Need to Address the Social Determinants of Health

Braveman, Paula A.,
Egerter, Susan A.,
Mockenhaupt, Robin E.
Journal Article
Year Published: 2011
Elsevier Inc.
American Journal of Preventive Medicine, 40(1S1): S4-S18, January 2011.
The Department of Family and Community Medicine, University of California San Francisco

This paper, adapted from "Overcoming Obstacles to Health: a Report from the Robert Wood Johnson Foundation to the Commission to Build a Healthier America," is intended to lay the foundation for this supplement to the American Journal of Preventive Medicine." After presenting new evidence produced for the commission about the extent of unrealized health potential in the U.S., the authors provide a brief overview of the science supporting a more comprehensive approach to reducing health disparities and improving health overall. They also summarize the case for taking societal action now to address the obstacles to health faced by many Americans. While ensuring that individuals have access to appropriate medical care and information about health-promoting behaviors remains important, they say that effective solutions also will require a broader focus on the contexts that powerfully shape both health behaviors and health itself. While much remains to be learned about which strategies are most effective, current knowledge is sufficient to indicate promising directions.

Correspondence to: Paula A Braveman, MD, MPH, Center on Social Disparities in Health, Department of Family and Community Medicine, University of California San Francisco, Box 0943, 3333 California Street, Suite 365, San Francisco, CA 94118; E-mail:, Website:
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