247246 Spirit of John Snow. A multi-dimensional, cross-disciplinary, multi-actor conceptual framework, used as a tool to improve and maintain public health

Wednesday, November 2, 2011: 9:16 AM

Shiriki K. Kumanyika, PhD, MPH , Department of Biostatistics & Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, PA
Geoffrey Cannon , American Institute for Cancer Research, Washington, DC
The ‘social determinants of health' concept is well understood and now commonly used. Health is indeed not just a consequence of chance or choice. Its determinants are also not only social. UNICEF developed the concept of the ‘immediate', ‘underlying' and ‘basic' causes of disease and well-being. This concept has been further developed by the World Cancer Research Fund/ American Institute for Cancer Research, in its 2009 report on policy and action for cancer prevention, in a broad public health context. The conceptual framework used in this report – and in executive summaries prepared for Latin America and Brazil in partnership with the Pan American Health Organization and the Brazilian National Cancer Institute, and for the US in association with APHA – includes economic and physical environmental as well as social and personal dimensions. It is applied at global, national, local and personal levels and includes drivers of public health that cannot yet be quantified, such as economic globalization and climate change. It is used as a method to engage relevant actors synergistically, including international bodies, government, civil society organizations, industry, the media, schools, workplaces and institutions, health and other professionals, and people as members of households and communities and citizens as well as individuals. This presentation will give results from various studies that show how the system works. It will apply the framework to examples where the best available evidence can be progressed to rational public health policies and effective actions, where there is an urgent need.

Learning Areas:
Chronic disease management and prevention
Communication and informatics
Public health or related laws, regulations, standards, or guidelines
Public health or related public policy
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Identify the overall determinants of disease and health. Compare this conceptual framework with others. Evaluate the framework in specific settings as appropriate.

Keywords: System Involvement, Public Policy

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I was chair of the Institute of Medicine report panel whose report 'Bridging the Evidence Gap in Obesity Prevention' which advocates systems work, was published last year. I was a member of the WCRF/AICR panels on prevention of cancer and its policy implications, published in 2007 and 2009, also advocate systems work, and I advised AICR on the summaries of the policy report for Latin America. All these documents themselves use systems approaches. I have been for some years an officer of APHA
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.