title: Identifying vulnerable populations using a social determinants of health framework: analysis of national survey data across six Asia-Pacific countries.
abstract: BACKGROUND
  In order to improve the health of the most vulnerable groups in society, the WHO called for research on the multiple and inter-linking factors shaping the social determinants of health (SDH). This paper analyses four key SDH (social cohesion, social inclusion, social empowerment and socioeconomic security) across six Asia-Pacific countries: Australia, Hong Kong, Japan, South Korea, Taiwan, and Thailand.
  
  
  METHODS
  Population surveys were undertaken using a validated instrument in 2009-10, with sample sizes around 1000 in each country. The four SDH were analysed using multivariate binomial logistic regression to identify socio-demographic predictors in each country.
  
  
  RESULTS
  Low socio-economic security was associated with low income in all six study countries and with poor subjective health in Japan, South Korea and Thailand and with being married or cohabiting in Australia and Hong Kong. Low social cohesion was associated with low income in all countries and with undertaking household duties in South Korea, Thailand and Taiwan. Low social inclusion was associated with low income in Australia, South Korea and Taiwan and with poor subjective health in Australia, Japan and South Korea. Older people had lower social inclusion in Taiwan (50-59 years) and Hong Kong (retired), younger people in Japan and South Korea (20-29 years in both countries) and younger and middle-aged people in Australia. Low social empowerment was associated with low income in Australia, Thailand and Taiwan, with being aged 60 years or over in Australia, Hong Kong and South Korea, and over 50 years in Thailand.
  
  
  CONCLUSIONS
  This paper provides baseline measures for identifying where and how policy should be altered to improve the SDH. Furthermore, these data can be used for future policy evaluation to identify whether changes in policy have indeed improved the SDH, particularly for marginalised and vulnerable populations.
authors.affiliation: Discipline of Public Health, Flinders University, Adelaide, South Australia, Australia.
authors.forename: Paul R
authors.initials: PR
authors.lastname: Ward
authors.affiliation: Discipline of Public Health, Flinders University, Adelaide, South Australia, Australia.
authors.forename: Loreen
authors.initials: L
authors.lastname: Mamerow
authors.affiliation: School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada.
authors.forename: Samantha B
authors.initials: SB
authors.lastname: Meyer
mesh_terms: D000328:Adult; D001210:Asia, Southeastern; D001315:Australia; D003695:Delivery of Health Care; D005191:Family Characteristics; D005260:Female; D006291:Health Policy; D006801:Humans; D008297:Male; D008875:Middle Aged; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires