Objective: This study aims to enhance health and well-being by clarifying the definition and background of the concept of Social Determinants of Health (SDH) and its application in healthcare practice. Methods: By reviewing current documents, we describe 1) definitions, related concepts, and their backgrounds; 2) the application of the concept domestically and internationally; and 3) the application of the concept in healthcare. We also derive insights to further promote the introduction of the SDH concept. Results: 1) Definitions, related concepts, and background: According to the World Health Organization (WHO), the determinants of health (DH) that affect health outcomes and healthy life expectancy comprise the factors surrounding individuals or groups, such as social, economic, commercial, and physical environments. These factors can lead to health inequities. Among these, SDH are social matters, such as systems and authority. While some DH are immutable, SDH that can be modified include personal behavior and lifestyle. Addressing these factors through policies and multisectoral activities are necessary to promote health and reduce inequities. 2) History of these concepts in Japan and other countries: Health inequities and their influencing factors have been noted since the 1970s. In 1991, Dahlgren and Whitehead proposed a model depicting individuals and DH, including social factors, in layered sections like a rainbow. In 1998, the WHO adopted Marmot and Wilkinson’s SDH concept, defining it as modifiable socio-cultural-economic conditions that cause health inequalities and inequities among individuals or groups. Specifically, they showed evidence for ten items, including social gradient, stress, and unemployment. The WHO officially adopted SDH in 2005, and the Rio Political Declaration on Social Determinants of Health in 2011 required all member countries to implement SDH policies. Despite Japan being behind the UK and the US, the 2013 “Health Japan 21 (the second term)” policy aimed to eliminate health inequities in Japan. 3) Application of the concept in the healthcare field: Since 2017, efforts have been made in Japan to incorporate SDH into healthcare services to reduce health inequities, and SDH has become a required subject in medical and nursing undergraduate education. Conclusions: There is a need to further disseminate SDH and strengthen healthcare practices, both domestically and internationally, to eliminate health inequities.

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