In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.

Social justice has always been a core value driving public health. Today, much of the etiology of avoidable disease is rooted in inequitable social conditions brought on by disparities in wealth and power and reproduced through ongoing forms of oppression, exploitation, and marginalization. Tackling Health Inequities raises questions and provides a starting point for health practitioners ready to reorient public health practice to address the fundamental causes of health inequities. This reorientation involves restructuring the organization, culture and daily work of public health. Tackling Health Inequities is meant to inspire readers to imagine or envision public health practice and their role in ways that question contemporary thinking and assumptions, as emerging trends, social conditions, and policies generate increasing inequities in health.

What are the connections between healthy bodies, healthy bank accounts and skin colour? Our opening episode travels to Louisville, Kentucky, not to explore whether medical care cures us but to see why we get sick in the first place, and why patterns of health and illness reflect underlying patterns of class and racial inequities. The lives of a CEO, a lab supervisor, a janitor, and an unemployed mother illustrate how class shapes opportunities for good health. Those on the top have the most access to power, resources and opportunity and thus the best health. Those on the bottom are faced with more stressors unpaid bills, jobs that don't pay enough, unsafe living conditions, exposure to environmental hazards, lack of control over work and schedule, worries over children and the fewest resources available to help them cope. The net effect is a health-wealth gradient, in which every descending rung of the socioeconomic ladder corresponds to worse health. And it's not just the poorest among us who are suffering, but the middle classes too. Louisville Metro Public Health Department data maps reveal 5- and 10-year gaps in life expectancy between the city's rich, middle and working-class neighborhoods. We also see how racial inequality imposes an additional burden on people of colour. But how do racism and class get under the skin? Experiments with monkeys and humans shed light on chronic stress as one culprit. Like gunning the engine of a car, constant activation of the stress response wears down the body's system, resulting in higher rates of disease and early death. Compared to other countries, the U.S. has the greatest income inequality and the worst health. Today, the top one percent of Americans owns more wealth than the bottom 90% combined. Economic inequality is greater than at any time since the 1920s. One out of every 5 children in the U.S. lives in poverty (21%) compared with approximately 4% of Sweden. Social spending makes up most of the difference: in Sweden, social spending reduces child poverty by 70%, while in the U.S. it reduces child poverty only 5%, down from 26%. Solutions being pursued in Louisville and elsewhere focus not on more pills but on more equitable social policies. Louisville's new Center for Health Equity is the first of its kind: a collaboration between community members, local government, private business and health care organizations focusing on the social conditions that underlie our opportunities for health and wellbeing.

And political foundations of the welfare state, and indeed about our most basic concepts of citizenship and national identity

The primary factors that shape the health of Canadians are not medical treatments or lifestyle choices but rather the living conditions they experience. These conditions have come to be known as the social determinants of health. This information - based on decades of research and hundreds of studies in Canada and elsewhere - is unfamiliar to most Canadians. Canadians are largely unaware that our health is shaped by how income and wealth is distributed, whether or not we are employed and if so, the working conditions we experience. Our health is also determined by the health and social services we receive, and our ability to obtain quality education, food and housing, among other factors. And contrary to the assumption that Canadians have personal control over these factors, in most cases these living conditions are - for better or worse - imposed upon us by the quality of the communities, housing situations, work settings, health and social service agencies, and educational institutions with which we interact. Improving the health of Canadians requires we think about health and its determinants in a more sophisticated manner than has been the case to date. Social Determinants of Health: The Canadian Facts considers 17 social determinants of health: 1. Income and Income Distribution 2. Education 3. Unemployment and Job Security 4. Employment and Working Conditions 5. Early Child Development 6. Food Insecurity 7. Housing 8. Social Exclusion 9. Social Safety Net 10. Health Services 11. Geography 12. Disability 13. Indigenous Ancestry 14. Gender 15. Immigration 16. Race 17. Globalization The publication outlines why they are important; how Canada is doing in addressing them; and what can be done to improve their quality. The purpose of the document is to provide promote greater awareness of the social determinants of health and the development and implementation of public policies that improve their quality.

To advance the epidemiological analysis of social inequalities in health, and of the ways in which population distributions of disease, disability, and death reflect embodied expressions of social inequality, this volume draws on articles published in the "International Journal of Health Services" between 1990 and 2000. Framed by ecosocial theory, it employs ecosocial constructs of "embodiment"; "pathways of embodiment"; "cumulative interplay of exposure, susceptibility, and resistance across the lifecourse"; and "accountability and agency" to address the question; and who and what drives current and changing patterns of social inequalities in health.