Social Determinants of Infections: A European Perspective

The European Centre for Disease Prevention and Control (ECDC) is a new EU agency, founded in the aftermath of the SARS pandemic and at the dawn of the recurrent avian influenza outbreaks in 2003, with the mandate to identify, assess and communicate current and emerging threats to human health from communicable diseases. While infectious disease mortality in Europe has been dramatically pushed back over the last century communicable diseases remain a public health threat, especially in certain sub-populations. Through a systematic literature review discrepancies between groups within virtually every country in Europe have been documented for a wide variety of communicable diseases: poor educational attainment, low income, or other socioeconomic factors result in the inequitable distribution of communicable diseases. Disadvantaged groups experience greater exposures with increased vulnerability due to environmental or behavioural risk factors and tend to lack access to health care to prevent adverse consequences of disease. Tuberculosis and HIV are now endemic in certain sub-populations while vaccine-preventable diseases and other communicable diseases disproportionally affect marginalized groups.

Evidence-based public health, social determinants of health, and strategic interventions targeting up-stream causes of communicable disease transmission should be considered as a long-term approach to public health in Europe. Results from a recent conference addressing social determinants of communicable diseases at ECDC with European public health professionals will be presented.