ArticleThe Milbank quarterly2024
Keeping It Political and Powerful: Defining the Structural Determinants of Health.
Article in The Milbank quarterly, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 66 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
66 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Structural Vulnerability in Health Research: A Systematic Mixed Studies Review.Journal of advanced nursing · 2026Pooled it
- Insecure employment and the social determinants of suicide: a narrative synthesis review.Globalization and health · 2026Pooled it
- Association between oral health-related quality of life and structural determinants of health among elderly populations. a systematic review and meta-analysis.International journal for equity in health · 2025Pooled it
- Trial
- Building a Culture of Health Through the Built Environment: Impact of a Cluster Randomized Trial Remediating Vacant and Abandoned Property on Health Mindsets.Journal of urban health : bulletin of the New York Academy of Medicine · 2025Trial
- Comparing the Illness Perception, Help-Seeking Behaviors, and Healthcare Determinants Between the Rural and Suburban Indigenous People in Malaysia: A Socio-Biological Perspective.Journal of racial and ethnic health disparities · 2026Article
- Precision Prevention for Health: The Global Alliance Framework for the Promotion of Physical Activity.Sports medicine (Auckland, N.Z.) · 2026Article
- Sociocultural and Structural Determinants of Black Maternal Mental Health: A Scoping Review.Birth (Berkeley, Calif.) · 2026Article
- Inequities in access to palliative care and community-based indigenous palliative care programs in Canada: a scoping review.BMC palliative care · 2026Article
- Structural and Intermediate Social Determinants of Health Linked to Adolescent Pregnancy in the Peruvian Rural Context.International journal of environmental research and public health · 2026Article
- Why Evidence Is Not Enough: Power, Politics, and a Strategy Shift for Public Health.The Milbank quarterly · 2026Article
- The Relationship between Social Vulnerability Index, Area Deprivation Index, and Child Opportunity Index, and Treatment Course Characteristics in Infants with Surgically Intervenable Congenital Anomalies.American journal of perinatology · 2026Article
- Moving Beyond the Individual Latino/Hispanic Health Paradox: Centering the Social and Structural Context in Latino/Hispanic Cardiovascular Health Research.Journal of general internal medicine · 2026Article
- Structural determinants and health-related quality of life among people living with HIV: a systematic review and meta-analysis protocol.Systematic reviews · 2026Article
- Addressing the commercial determinants of unhealthy beverage exposure: a systems thinking approach.Globalization and health · 2026Article
- Addressing Structural Factors to Prevent Youth Violence Through a Multisector Collaborative Approach.Prevention science : the official journal of the Society for Prevention Research · 2026Article
- Clarifying the social and structural determinants of health and health inequities: refining and extending a conceptual framework.Health promotion international · 2026Article
- Community Assets as Protective Factors Buffering Health Effects of Environmental Hazards: Framework and Considerations for Environmental Epidemiologists.Environmental research, health : ERH · 2026Article
- Contextualizing Age-Friendly Care Within Social Drivers of Health.Journal of the American Geriatrics Society · 2026Article
- Trauma descriptions and lived experiences: a phenomenological exploratory study among patients with severe mental illness in Botswana.BMC psychiatry · 2026Article
6 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
Abstract
Policy Points The structural determinants of health are 1) the written and unwritten rules that create, maintain, or eliminate durable and hierarchical patterns of advantage among socially constructed groups in the conditions that affect health, and 2) the manifestation of power relations in that people and groups with more power based on current social structures work-implicitly and explicitly-to maintain their advantage by reinforcing or modifying these rules. This theoretically grounded definition of structural determinants can support a shared analysis of the root causes of health inequities and an embrace of public health's role in shifting power relations and engaging politically, especially in its policy work. Shifting the balance of power relations between socially constructed groups differentiates interventions in the structural determinants of health from those in the social determinants of health.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.