TY - JOUR T1 - Going global with social determinants of health: some reflections JF - BMJ Global Health JO - BMJ Global Health DO - 10.1136/bmjgh-2022-009799 VL - 7 IS - 6 SP - e009799 AU - Sridhar Venkatapuram Y1 - 2022/06/01 UR - http://gh.bmj.com/content/7/6/e009799.abstract N2 - The article by Abdalla et al1 raises some interesting points and presents a timely opportunity to reflect on aspects of the continuously evolving academic, policy and public engagement with ‘social determinants of health’ (SDOH). The study focuses on public understanding of SDOH, and surveyed people across eight countries (Brazil, China, Germany, Egypt, India, Indonesia, Nigeria and the USA). The top line finding is that across countries the people surveyed consistently ranked healthcare as the most important determinant of health (among a list of options) except in China. There, respondents ranked education first then, healthcare.Aside from selecting and ranking their top three determinants of health, respondents were also asked about how they think policymakers might rank top three health determinants. From the results, the researchers conclude that as found elsewhere, the respondents ranked downstream/proximate causes (eg, personal behaviour, genetics, healthcare and so on) as the most important determinants of health versus policymakers who might rank higher the upstream/distal-macro or social determinants (eg, politics, employment conditions and so on). What is unclear is why the list of options included both proximate determinants of health such as genetics and healthcare as well as some SDOH. It is also not clear why personal behaviours/choices were not included if the list contained the most common kinds of both determinants.Nevertheless, the two big findings align with what is already known from surveys of public understanding of SDOH in high-income countries (HICs).2 The potentially novel findings have to do with differences in second and third rankings. For example, Egyptians ranked education and culture as being important. Could it be that education is seen as an antidote to ignorance about disease causation and/or informs good health practices? Is culture seen to provide health protecting religious/moral behaviours? And, why would respondents in the USA and … ER -