Health is going in the wrong direction in the UK, and reversing the trend requires political and societal commitment to deal with the underlying causes
The UK is facing a prolonged and serious health crisis. At a time when the future of the NHS is in jeopardy after over a decade of austerity, and with public satisfaction at an all time low,1 it must pick up the pieces of failures across government. Attaining good health requires more than healthcare, and improvements in the provision of healthcare by the NHS alone is inadequate to address the health crisis—action is needed on the social determinants of health2 (box 1).
Box 1 ### Definition of social determinants of health3
The social determinants of health are defined by the World Health Organization as: “the conditions in which people are born, grow, live, work, and age, and the wider set of forces and systems shaping the conditions of daily life. These forces and systems include economic policies and systems, development agendas, social norms, social policies, and political systems.”RETURN TO TEXT
In this paper, we propose evidence based solutions to the worsening health and widening inequalities in the UK through action on the social determinants of health. (A separate article within the commission is focused on health equity.4) We first outline the problem of deteriorating health across the UK. We then provide an overview of the evidence, showing how action on the social determinants can improve health. We confront the challenging political nature of this area, including rebuttal of criticisms of interventions as actions of a “nanny state” and the neoliberal focus on individualism. Finally, we offer action focused solutions and recommendations on what NHS workers, leaders of NHS organisations and integrated care systems, and the government can do to urgently deal with the deteriorating health of the population.