Communicating about social determinants of health, inequities: The Krieger Challenge

Being interested in Health Promotion and Health Communication, I am very interested in where they meet (in fact, in 1996 Irv Rootman and I published a paper in which we defined Health Communication as where health promotion and health communication meet !)

In the following post, I visit a  call to action by Nancy Krieger,  follow that up with  Canadian and US “snapshots,” and close with two learning resources about communications.

Krieger’s article  included some interesting conclusions, as well as an array of visual representations of determinants of health.

In it, she calls for an “iconoclastic iconography, one that clearly delineates the social facts of skewed distributions of power and resources and depicts the social processes that…”  Which is not often the case!

What do you think of her recommendation?

For appropriate background, please read the article, abstracts, or other works by her:

J Epidemiology and Community Health. 2008 Dec;62(12):1098-104. doi: 10.1136/jech.2008.079061.
Ladders, pyramids and champagne: the iconography of health inequities.
Krieger N.

For a real world USA discussion of semantics around the “redistribution” word, check out an article in the New York Times by John Harwood:

George Lakoff who developed a lot of the thinking around framing was a high-powered consultant to the Democratic Party……


For a Canadian take on how we communicate about social determinants of health, read Beyond ‘Run, Knit and Relax’: Can Health Promotion in Canada Advance the Social Determinants of Health Agenda?

Ted Schrecker


One learning resource is a Physics Today article by Somerville and Hassol, found at the following link:


A second learning resource is a series of lectures hosted by Spitfire Strategies:

About Larry Hershfield
I have been developing innovative services and products for the public health community since 1975.

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