What can public health do to address inequities in infectious disease?
The recognition of the importance of social conditions informed early public health responses to infectious disease epidemics. By influencing exposure, vulnerability, and access to health services, social determinants of health (SDOH) continue to cause inequalities in infectious disease distribution. Such preventable and unjust inequalities are considered to be inequities. A number of challenges and barriers exist to more widespread public health action that addresses SDOH and inequities, including a lack of clarity on what public health should or could do. The National Collaborating Centre for Determinants of Health (NCCDH) has identified four primary roles for public health action on SDOH and inequities. This paper describes these roles and includes examples of their application to infectious diseases. The critical contribution that organizations make in providing the leadership and support for programs and staff to pursue action on SDOH and inequities is also highlighted. While the challenge is large and complex, approaches such as the NCCDH roles for public health action provide a menu of options to facilitate the analysis and action to address SDOH and inequities in infectious diseases.