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From knowledge accumulation to transformative action: research to catalyze progress on social determinants of health equity
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DOI：10.1186/s12939-026-02900-4.png)
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Abstract
En 中文
Despite three decades of expanding scholarship on social determinants of health (SDH), progress in reducing health inequities has remained limited. While the SDH framework has reshaped global health discourse and informed policy rhetoric, the translation of knowledge into transformative action has been insufficient. The gap between evidence and impact is not explained by political constraints alone but is also contributed to by the orientation, methods, and practices of SDH research itself. We identify key limitations in what is studied, how research is conducted, and who leads knowledge production. Thematic gaps include the dominance of descriptive research, limited evidence on effective policy interventions, insufficient engagement with structural determinants and political economy, and underdeveloped attention to emerging drivers such as climate change, digitalization, and commercial determinants. Methodological limitations include underuse of policy, implementation, modelling, and participatory approaches, alongside persistent data gaps. Deficiencies in research practice constrain the transformative potential of SDH scholarship, including a lack of multi-disciplinary work, limited community and policymaker engagement and leadership, and inequitable power dynamics in global health research itself. We propose a reorientation of SDH research toward agency and action with greater focus on solutions and implementation pathways, methodological pluralism, multisectoral and participatory knowledge production, improved communication and policy engagement, and reforms to research incentives, funding and governance. By repositioning SDH research as an active contributor to political and institutional change, researchers can more effectively support equitable and sustainable health outcomes in a global context increasingly inhospitable for attention to health equity. Despite extensive evidence on social determinants of health, research has not translated into sufficient policy action or sufficient measurable reductions in health inequities. Dominant research approaches remain overly descriptive, insufficiently focused on solutions, and inadequately engaged with structural, political, and economic drivers of inequity. Underuse of policy, implementation, modelling, and participatory methods, alongside limited multisectoral collaboration, inadequate engagement with political actors and cycles, and inequitable power dynamics in research, constrain impact. SDH research must shift from documenting inequities and presenting normative recommendations to generating actionable, context-sensitive evidence that informs feasible policy design, implementation, and political strategy. Advancing health equity requires methodological pluralism, multisectoral and community-led knowledge production, stronger engagement with policymakers, and reforms to research incentives and communication practices.
Keywords:
Health equity
Social determinants of health
Health policy
Health systems
Research agenda
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