FIGURE 2-1 A guide to thinking about the determinants of population health. The model was originally adapted from Dahlgren and Whitehead (1991). The dotted lines between levels of the model denote interaction effects between and among the various levels of health determinants.

^aSocial conditions include economic inequality, urbanization, mobility, cultural values, and attitudes and policies related to discrimination and intolerance on the basis of race, sex, and other differences. Although race is an individual characteristic, its influence on health is strongly influenced by the social context of race.

^bOther conditions at the national level might include major sociopolitical shifts, such as recession, war, and government collapse.

^cThe built environment includes transportation, water and sanitation, housing, and other dimensions of urban planning.

SOURCE: IOM (2002a).