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National Health Act, 2003 (Act No. 61 of 2003)


National Health Insurance Policy towards Universal Health Coverage

Chapter 3 : Problem Statement

3.1 Social Determinants of Health (SDH)


40. Health is influenced by the environment in which people are born, grow up, live and work, and societal risk conditions are also more important than individual ones in the spread of a disease. This includes exposure to polluted environments, inadequate housing and poor sanitation. Health is shaped by multiple epidemics, as well as powerful historical and social forces, such as vast income inequalities, unemployment, poverty, racial and gender discrimination, the migrant labour system, the destruction of family life and extreme violence.


41. South Africa’s health system is also influenced by these societal risk conditions. It is characterized by the quadruple burden of disease disproportionately affecting lower socio-economic groups compounded by lower health service utilisation rates. Lower socio-economic groups also derive fewer benefits from using health care (both in the public and private sectors), than higher socio-economic groups22.


42. Vision 2030 of the National Development Plan (NDP) recommends that, based on the WHO Commission on the SDH, South Africa must enhance its efforts in the following three areas namely: (a) Improve the conditions of daily life; (b) Tackle the inequitable distribution of power, money, and resources; and (c) Measure the problem, evaluate actions, expand the knowledge base, develop a trained workforce in the social determinants of health and raise public awareness.