Public social monitoring reports and their effect on a policy programme aimed at addressing the social determinants of health to improve health equity in New Zealand Frank Pega a, b, * , Nicole B. Valentine c , Don Matheson d , Kumanan Rasanathan e a Department of Public Health, University of Otago, PO Box 7343, Wellington, New Zealand b Department of Social and Behavioral Sciences, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, United States c Department of Ethics and Social Determinants of Health, Health Systems and Innovation Cluster, World Health Organization, 20 Avenue Appia, CH-1211 Geneva 27, Switzerland d Centre for Public Health Research, Massey University e Wellington Campus, Private Box 756, Wellington, New Zealand e Health Section, United Nations Children’s Fund (UNICEF), 3 UN Plaza, New York, NY 10022, United States article info Article history: Available online 15 November 2013 Keywords: New Zealand Health policy Social determinants of health Health equity Social monitoring Social reporting abstract The important role that monitoring plays in advancing global health is well established. However, the role of social monitoring as a tool for addressing social determinants of health (SDH) and health equity- focused policies remains under-researched. This paper assesses the extent and ways in which New Zealand’s (NZ) Social Reports (SRs) supported a SDH- and health equity-oriented policy programme nationally over the 2000e2008 period by documenting the SRs’ history and assessing its impact on policies across sectors in government and civil society. We conducted key-informant interviews with five senior policy-makers and an e-mail survey with 24 government and civil society representatives on SRs’ history and policy impact. We identified common themes across these data and classified them accordingly to assess the intensity of the reports’ use and their impact on SDH- and health equity-focused policies. Bibliometric analyses of government publica- tions and media items were undertaken to empirically assess SRs’ impact on government and civil society. SRs in NZ arose out of the role played by government as the “benevolent social welfare planner” and an understanding of the necessity of economic and social security for “progress”. The SRs were linked to establishing a government-wide programme aimed at reducing inequalities. They have been used moderately to highly in central and local government and in civil society, both within and outside the health sector, but have neither entered public treasury and economic development departments nor the commercial sector. The SRs have not reached the more universal status of economic indicators. However, they have had some success at raising awareness of, and have stimulated isolated action on, SDH. The NZ case suggests that national-level social monitoring provides a valuable tool for raising awareness of SDH across government and civil society. A number of strategies could improve social reports’ effectiveness in stimulating action on SDH. Ó 2013 Elsevier Ltd. All rights reserved. Introduction To improve health equity, international organizations, govern- ments and civil society need to develop an understanding of health inequities and implement policies leading to action on social de- terminants of health (SDH) beyond the health sector (CSDH, 2008). The World Health Organization (WHO) Commission on Social De- terminants of Health (CSDH) emphasized the vital role that monitoring plays in improving health equity with its third over- arching recommendation that stressed the need “to measure and understand the problem and to assess the impact of action” (2008, p. 2). Supporting the implementation of the Commission’s recom- mendations, the Rio Political Declaration on Social Determinants of Health (WHO, 2011) pledged actions “to monitor progress and in- crease accountability” (p. 6) as one of five action areas. The Sixty- Fifth World Health Assembly (2012) passed a resolution urging Member States “to implement the pledges made in the Rio Political Declaration on Social Determinants of Health” (p. 2), reiterating the importance of monitoring progress. * Corresponding author. PO Box 7343, Wellington, New Zealand. E-mail address: frank.pega@otago.ac.nz (F. Pega). Contents lists available at ScienceDirect Social Science & Medicine journal homepage: www.elsevier.com/locate/socscimed 0277-9536/$ e see front matter Ó 2013 Elsevier Ltd. All rights reserved. http://dx.doi.org/10.1016/j.socscimed.2013.10.043 Social Science & Medicine 101 (2014) 61e69