Abstract:
Social determinants of health (SDH) are usually understood as circumstances and
structures that disadvantage individuals by increasing their vulnerability to disease
and injury. In this model social determinants of health act upon individuals and communities
who are relatively powerless to react against the health impacts of factors
such as poverty and marginalization. With the aim of expanding the concept of social
determinants, we examine the role human rights-based activism can play in improving
health outcomes by exploring two well-known cases: activism through
Brazil’s National Health Council, and HIV activism by South Africa’s Treatment
Action Campaign (TAC). Drawing on these cases we argue that, in addition to the
valuable current and historical conceptions of social determinants of health as contextual
factors that act upon people, social determinants can and should also be understood
as processes of participation and engagement whereby individuals are
able, through their own knowledge and actions, to improve health outcomes for
themselves and others. Building on a phrase proposed by Heywood, we posit that
human rights-based activism can be an influential agency-based social determinant
of health.
