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 Social Determinants of Health (SDH) theory, as advanced by the World Health Organization Commission on Social Determinants of Health, as a framework for analysing Orang Asli health equity. Using a conceptual review approach, the article synthesises peer-reviewed studies, official reports, and foundational SDH literature on Indigenous health, health equity, land dispossession, food security, and healthcare access. Through the Rainbow Model by Dahlgren and Whitehead and the WHO Conceptual Framework for Action on the Social Determinants of Health, the paper discusses how health inequities among Orang Asli populations are shaped by structural determinants, including socioeconomic position, political governance, historical marginalisation, and land insecurity, as well as intermediary determinants such as living conditions, food insecurity, and access to culturally appropriate healthcare. The analysis demonstrates the importance of a culturally sensitive, rights-based, and decolonial SDH framework for addressing Indigenous health inequities in Peninsular Malaysia.