Foreword, by David R. Williams

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Chapter 1

The Allegory of the Orchard: The Political Determinants of Health Inequities

Chapter 2

Setting the Precedent: America's Attempts to Address the Political Determinants of Health Inequities

Chapter 3

The Political Determinants of Health Model

Chapter 4

How the Game Is Played: Successful Employment of the Political Determinants of Health

Chapter 5

Winning the Game That Never Ends: Success Means Continuous Employment of the Political Determinants of Health

Chapter 6

Growing Pains: Tackling the Political Determinants of Health Inequities during a Challenging Period

Chapter 7

The Future of Health Equity Begins and Ends with the Political Determinants of Health

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Table of Contents

New Release!

"Daniel Dawes's groundbreaking and illuminating work on the political determinants of health will change how we think about the drivers of our health and well-being. It is one of the most important books in health policy to be written in years."

— Thomas A. LaVeist, PhD,

Tulane University School of Public Health and Tropical Medicine

"This essential text sets a bold new agenda for health justice. Dawes' pathbreaking work will shape the global conversation around the political determinants of health for generations to come."

— Lindsay F. Wiley, JD, MPH,

Washington College of Law, American University

"Daniel Dawes makes an engaging and important contribution to the health equity discourse with this book. He is also one of the few people in the country who could make this contribution. Because Dawes has been intimately engaged in the workings of government, he has a deep firsthand understanding of the political determinants of health. Moreover, he has a sweeping view of the historical movements that have contributed to the complexities of the American health care system. Dawes brings all of these threads to bear in this book and manages to make them relevant to the health equity movement today."

— Dayna Bowen Matthew, JD, PhD,

University of Virginia Law School

"Daniel Dawes brilliantly exposes the single greatest determinant in producing and perpetuating health inequities in the United States and demonstrates a compelling way for us to elevate health equity for all groups."

— Garth Graham, MD, MPH,

Aetna Foundation / University of Connecticut School of Medicine

"Daniel Dawes insightfully argues that we have to be mindful of more than the social determinants of health. More specifically, he indicates that the political determinants of health are actually far more impactful and can be far more insidious when not properly addressed, given that the American political process is the foremost avenue for implementing change. He demonstrates that many challenges recognized as social determinants are the result of political determinants. I commend Professor Dawes for not only creating a detailed framework that outlines the political determinants of health but also providing us with timely enlightenment about the challenges that we are facing."

— David Williams, PhD, MPH,

Harvard T.H. Chan School of Public Health

"Daniel Dawes presents another thought-provoking book showing us why addressing social determinants of health, while critically important, is merely nibbling around the edges of the problem. This book lays the groundwork for a transformation in how we think about advancing health equity by tackling the political determinants of health."

— Brian Smedley, PhD,

American Psychological Association

"I have used Daniel Dawes's prior work, 150 Years of ObamaCare, in my classes for the last three years. The book provided the students with a solid foundation and important insight into the history of the Affordable Care Act and the US health equity movement. Dawes has now followed that with another groundbreaking book. In The Political Determinants of Health, he unveils a trailblazing model built on the latest evidence, clearly identifying the factors vital to any effective effort to address health inequities. The political determinants of health are key to understanding the myriad factors that contribute to inequities faced by underserved and marginalized communities. And they highlight a basic reality—that public health is inherently political. Dawes presents a road map for addressing the factors at the root of health outcomes in this country. This engaging book is a must-read for community members; policy makers; health professionals; social services professionals; behavioral health, public health, and health care leaders; advocates; academics; and future health professionals."

— Martha Moore-Monroy, MA,

Mel and Enid Zuckerman College of Public Health, University of Arizona

"After you read this book, you will never look at our health system in the same way again. Daniel Dawes has truly introduced an eye-opening perspective on the forces that affect our nation's health. This is required reading for all students in medical school, the health professions, and social services as well as for anyone who wants to change the status quo in health care."

— Krishnan Narasimhan, MD,

Howard University College of Medicine

"Politics shapes policy and policy impacts health. This text takes an insightful look at politics as a societal factor that determines public health. It is an essential read for anyone who strives to make the United States among the healthiest nations."

— Georges C. Benjamin, MD,

American Public Health Association

"The social determinants of health were an important advancement in our understanding of health. Now Daniel E. Dawes takes our understanding even further by developing a multidisciplinary framework explaining how policy and politics are tremendous drivers of the social conditions that affect all communities in a positive and negative way. Indeed, to truly address health, mental health, and substance use inequities, we need to understand their origins and their impact on the equitable distribution of opportunities and resources. The Political Determinants of Health does just that!"

— Octavio N. Martinez Jr., MD, MPH,

Hogg Foundation for Mental Health, The University of Texas at Austin

"This book shines a light on one of the most important aspects of modern life that impacts our nation's health. The role of politic and how it can diminish or worsen health equity has not been fully articulated in such a cohesive manner. This book will not only become an important guide for understanding health equity in America, but will also serve as an essential tool for academic training and mentoring in higher education."

— Mario Hernandez, PhD,

University of South Florida

"Daniel E. Dawes elucidates a critical front in the drive to advance health equity: political determinants of health. Wise public policies and public support are essential to dismantle the structural drivers of inequities and create payment reforms that support and incentivize the tailored care that reduces health disparities."

— Marshall H. Chin, MD, MPH,

The University of Chicago Pritzker School of Medicine

"According to the World Health Organization, the distribution of money, power, and resources at the global, national, and local levels is what ultimately shapes our health and survival. This puts health, health care, and health equity squarely in the political domain. By shining a powerful light on the political determinants of health, Dawes compels us to face critical drivers of health and well-being in the United States today."

— Laudan Aron, MA,

The Urban Institute

"Daniel E. Dawes continues to disrupt dominant narratives in this timely, ground-breaking book. So much of what creates and determines health happens outside of the doctor's office and hospital walls. Dawes pushes us all to move beyond our comfort zone of solely elevating the social and structural determinants of health and helps us to better understand the political drivers that produce optimal health for some and inequities for others."

— Aletha Maybank, MD, MPH,

Chief Health Equity Officer and Vice President, American Medical Association

"Daniel Dawes forces a conversation that we can no longer afford to ignore with this impressively original and powerful book. In The Political Determinants of Health, readers will be challenged, motivated, and inspired to adopt a more expansive view of the role that political determinants play on our nation's health. Arguably the most important book written on the driving force that has prevented us from realizing health equity in America and around the world."

— Patrick J. Kennedy,

Former congressman, founder of The Kennedy Forum, author of A Common Struggle: A Personal Journey through the Past and Future of Mental Illness and Addiction

"This book reframes the conversation around America's unequal health outcomes. It sheds light on why the current state of the nation's health did not happen by chance, but on purpose. It will force you to rethink the role social, environmental, economic and other factors play in influencing how long we will live."

— Regina Benjamin, MD, MBA,

18th US Surgeon General / Founder and CEO, Gulf States Health Policy Center

"I was immediately struck by Daniel Dawes's insights on the Political Determinants of Health. This new concept will deepen the space loosely captured by structural determinants of health with a more foundational anchor."

— Margaret P. Moss, JD (Hidatsa/Dakota),

Director, First Nations House of Learning; School of Nursing, University of British Columbia

"In his latest book, Daniel Dawes, a leader on health inequalities in the United States, takes a critical look at the work on the margins of the 'social determinants of health.' He pushes back, arguing that political determinants of health are the fundamental issue, requiring a global answer to begin to achieve health equity. I'm looking forward to sharing this book with my students."

— Carolyn A. Pointer, JD,

Southern Illinois University School of Medicine

"Daniel Dawes takes us further upstream to examine one of the most influential drivers that shape the health profile of our nation. The Political Determinants of Health offers invaluable insights for addressing the political, social, and economic factors that continue to adversely impact the health of diverse populations."

— Janice Phillips, PhD, RN, CENP, FAAN,

Director of Nursing Research and Health Equity, Rush University Medical Center and associate professor, Rush University College of Nursing

"In this riveting book, Dawes shifts behavioral health to the forefront and elucidates the limitations of our current approaches to addressing the determinants of health and how such approaches fall short in resolving the structural inequalities deep within our society."

— Arthur C. Evans, PhD,

Former Commissioner, Philadelphia Department of Behavioral Health and Intellectual disability Services

"The Political Determinants of Health provides a powerful lens through which to examine the structures, processes, and outcomes that account for unfair variations in health conditions among different groups. Because the United States is one of the most influential actors on the global stage, the insights from this in-depth study will illuminate our understanding of the pervasive inequities affecting health systems around the world. This is a must read for everyone who wants to be a transformative force for global health equity."

— Julio Frenk, MD, PhD,

President and professor of Public Health Sciences, University of Miami