If social determinants of health lead to death then we should list them on death certificates

I agree with air pollution being listed on death certificates.1 In principle, we should list all social determinants of health that have contributed to a death. It may be out of the hands of a clinician to stop these problems, but it would encourage local authorities and government to tackle the poor conditions many marginalised patients live in.I vividly remember the case of a patient who presented several times to the emergency department with an exacerbation of chronic obstructive pulmonary disease (COPD)—and who later died of an exacerbation of COPD and pneumonia. The patient took their medication and did not smoke but they lived in very damp conditions, with damp spreading from the window to the bed. No amount of steroids or antibiotics would have heated the home or fixed the double glazing. And no local authority would have been informed that someone had died from chronic exposure to mould…
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