The Social Determinants of Health Theory and Indigenous Health Equity: A Conceptual Perspective on Orang Asli Communities in Peninsular Malaysia

Abstract

The health disparities experienced by Orang Asli communities in Peninsular Malaysia constitute one of the most longstanding and complex public health issues in the country. This conceptual article examines the usefulness of the Social Determinants of Health (SDH) theory, as proposed by the World Health Organization Commission on Social Determinants of Health, as the framework for analysing the health status of Orang Asli populations. Through the application of the Rainbow Model by Dahlgren and Whitehead and the Conceptual Framework for Action on the Social Determinants of Health suggested by the WHO Commission, this paper discusses the ways in which health inequities among Orang Asli populations are influenced by structural determinants (socioeconomic position, political governance and historical marginalisation) and intermediary determinants (living conditions, food insecurity and health-care access). In addition, the paper will address how colonial dispossession, loss of ancestral lands and poor policy enforcement influence health vulnerabilities of Orang Asli communities. Based on the intersection of the SDH theory and the indigenous health approach, this paper will demonstrate the importance of using a culturally sensitive and rights-based framework for analyzing health inequalities among Orang Asli populations in Peninsular Malaysia.