As you have seen throughout this course there are considerable health inequalities in both morbidity and mortality. These inequalities have been largely persistent across time and have, in some cases, widened. You have also seen how health chances differ according to age, gender, ethnicity and socio-economic status.
The Lalonde Report (1974) recognised that health was more than healthcare and proposed that a multifactoral approach would be the best way to promote public health. Drawing on the influential framework proposed by Dahlgren and Whitehead (1991), this chapter has considered how each of the five layers they identify can influence health. A multifactoral explanation considers the role played by biology and genetics, lifestyle and behaviour, living and working conditions, social and community networks, and the wider social conditions in which individuals are located – not in isolation – but in relation to one another.