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DOI: 10.1177/1090198104265598 Social Determinants of Health: Implications for Environmental Health PromotionDepartment of Health Behavior and Health Education, University of Michigan, School of Public Health, Ann Arbor.
Mailman School of Public Health, Columbia University, New York. In this article, the authors draw on the disciplines of sociology and environmental and social epidemiology to further understanding of mechanisms through which social factors contribute to disparate environmental exposures and health inequalities. They propose a conceptual framework for environmental health promotion that considers dynamic social processes through which social and environmental inequalities—and associated health disparities—are produced, reproduced, and potentially transformed. Using empirical evidence from the published literature, as well as their own practical experiences in conducting community-based participatory research in Detroit and Harlem, the authors examine health promotion interventions at various levels (community-wide, regional, and national) that aim to improve population health by addressing various aspects of social processes and/or physical environments. Finally, they recommend moving beyond environmental remediation strategies toward environmental health promotion efforts that are sustainable and explicitly designed to reduce social, environmental, and health inequalities.
Key Words: social determinants of health • health disparities • environmental health promotion • health promotion interventions • population health
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