The Interchangeable Nature of Our Destinies: Health Inequities Born From Social and Structural Determinants of Health and the Advocacy Journey to Overcome Them

Abstract

As we explore what constitutes our unique experience as human beings and of disease, we recognize the pivotal role of circumstances and the fortune or misfortune of encountering them. In health, these circumstances—the social and structural determinants of health—can determine a disease phenotype and the extent to which a person can access quality care, acting as drivers for health disparities and social injustice. Unless we want to be bystanders to a status quo that is unjust to our patients and distressing to ourselves, we must engage with this critical aspect of their lives, giving it a place in our consultations and moving us to champion initiatives that can change the health policies that affect entire communities. Here, we highlight the advocacy journey of successful, data-driven initiatives across internationally diverse settings, which underscore the transformative power of advocacy-informed research in catalyzing change. By demanding change and advocating for policies that promote kidney health equity and inclusivity, they bridge the gap between individual health outcomes and systemic health inequities, thus giving rise to a universal language in medicine of humanism, empathy, and solidarity.