Societal Rules

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About

Societal rules are the written and unwritten rules and how they are applied to shape community conditions. Written rules may be formalized and documented in laws, policies, regulations and budgets. Unwritten rules are made up of worldviews, culture and norms. These can include customs or expectations that guide acceptable thought and behavior without being documented in writing. Institutional practices and systems of governance – such as an organization’s approach to salary parity – may be written or unwritten. Societal rules, and how they are created and maintained by those with power, are referred to as the structural determinants of health.

Relationship to health and equity

Societal rules shape the community conditions that impact how well and how long we live. Societal rules can directly address population health issues, such as through laws that require children to be vaccinated before attending public school. More often, societal rules shape the conditions that influence health and equity based on place, race and other societally constructed differences. For example, the Earned Income Tax Credit is a policy that offers a refundable income tax credit to low- and moderate-income individuals and families. There is strong evidence that the Earned Income Tax Credit increases employment and earnings for mothers and thereby improves maternal and child health.

Relationship to systems and structures

Past and present decisions form society’s rules. People and groups make these decisions and determine whether they are applied in an equitable manner. Creating and maintaining societal rules requires power, or the ability to achieve a purpose and to effect change.

Societal rules are often created through power over others. Leaving power in the hands of a few can create a path of advantage for some and disadvantage for many. Take, for example, structural racism —the ways society enables discrimination among populations perceived as being socially different from the racial or ethnic majority. Structural racism is embedded in society’s unwritten rules through a worldview that white people are superior. It is also reinforced through governance and institutional practices that apply regulations in an unequal manner across communities. Structural racism is also present in society’s written rules. Policies and laws, such as voter registration laws, can make it difficult for people who experience structural racism to have a say in the decisions that affect them. These rules, determined by people who wield power, create communities that have under-resourced schools, unsafe housing and limited access to health care, and deny people the conditions they need to be healthy.

Creating a future where no one has an advantage at the expense of others begins with understanding how our society has been structured by those who wield power. Working together, racialized and marginalized groups and their allies can change the rules to better serve our collective health and well-being.

Additional Reading

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