Health Affairs, 27, no. 2 (2008): 320 doi: 10.1377/hlthaff.27.2.320 © 2008 by Project HOPE	New Online   New Issue: China & India   Obesity In China   Pay Cuts For Medicare Docs   Access To Care Woes

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Social Determinants

PROLOGUE

The Social Determinants Of Health

The Lalonde report of 1974 (issued by then Canadian minister of national health and welfare Marc Lalonde) popularized the idea that direct medical care might be but a bit player in producing health and reducing mortality. That report highlighted the fact that other factors—biology, environment, lifestyle—figure more prominently than medical care in producing health. The report also noted a striking disparity between this finding and the shares of income devoted to various determinants of health. Indeed, although estimates of the effect of improved medical care on reductions in mortality hover around 10–15 percent, public policy and investment in this country . . . [Full Text of this Article]

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