The social determinants of maternal-child health in American countries are discussed on the basis of the analysis of several papers and official recommendation. Many of these studies do not place due emphasis on social factors. Indeed, social factors are frequently put on the same level as biological ones. Therefore, the resulting understanding is distorted. Conclusions and recommendations from such studies should be accepted with some caution since they do not get to the root of the problems. Different social variables (like mother's education or medical care) are often associated with biological ones (like birth weight or nutritional status). However, this cannot be taken to establish a cause-effect relationship among those variables, but only the simultaneous occurrence of the characteristic features of social class. The authors maintain that different social classes be recognized and compared since such a comparison can better explain the results in this field. The necessity of new research which takes into account the social factors as more important than the biological ones is stressed. These would probably establish the social importance of the maternal-child health issue and avoid the recent purely technical guidelines and recommendations.
Maternal health services; Child health services; Health program