Social epidemiology

Last updated

While epidemiology is "the study of the distribution and determinants of states of health in populations", social epidemiology is "that branch of epidemiology concerned with the way that social structures, institutions, and relationships influence health." [1] This research includes "both specific features of, and pathways by which, societal conditions affect health". [2] [3]

Although health research is often organized by disease categories or organ systems, theoretical development in social epidemiology is typically organized around factors that influence health (i.e., health determinants rather than health outcomes). Many social factors are thought to be relevant for a wide range of health domains. Social epidemiology can therefore address any health outcome, including chronic disease, infectious disease, mental health, and clinical outcomes or disease prognosis. Exposures of interest to social epidemiologists include individual-level measures (e.g., poverty, education, social isolation), contextual factors (e.g., residential segregation or income inequality), and social policies (e.g., policies creating income security or promoting educational access). Analyses that address the independent or synergistic effects of individual or contextual risk factors are often of interest. [4] Understanding the origins of health disparities and identifying strategies to eliminate health disparities is a major focus of social epidemiology.[ citation needed ]

Major research challenges in social epidemiology include tools to strengthen causal inference, [5] [6] methods to test theoretical frameworks such as Fundamental Cause Theory, [7] translation of evidence to systems and policy changes that will improve population health, [8] and mostly obscure causal mechanisms between exposures and outcomes. [9] To address obscurity of causal mechanisms in social epidemiology, it has been proposed to integrate molecular pathological epidemiology into social epidemiology. [9]

For example, questions of interest to epidemiologists include:[ citation needed ]

Social epidemiology draws on methodologies and theoretical frameworks from many disciplines, and research overlaps with several social science fields, most notably economics, medical anthropology, medical sociology, health psychology and medical geography, as well as many domains of epidemiology. However, intersecting social science fields often use health and disease in order to explain specifically social phenomenon (such as the growth of lay health advocacy movements), [10] while social epidemiologists generally use social concepts in order to explain patterns of health in the population.[ citation needed ]

More recently, the discipline is moving from identifying health inequalities along the social gradient to identifying the policies, programmes and interventions that effectively tackle the observed socioeconomic inequalities in health. Researchers Frank Pega and Ichiro Kawachi from Harvard University have suggested that this may lead to the new discipline of Political Epidemiology, which is more policy-applied in that it identifies effective and cost-effective social interventions for government action to improve health equity. [11]

Related Research Articles

<span class="mw-page-title-main">Epidemiology</span> Study of health and disease within a population

Epidemiology is the study and analysis of the distribution, patterns and determinants of health and disease conditions in a defined population.

The science of epidemiology has matured significantly from the times of Hippocrates, Semmelweis and John Snow. The techniques for gathering and analyzing epidemiological data vary depending on the type of disease being monitored but each study will have overarching similarities.

In epidemiology, a risk factor or determinant is a variable associated with an increased risk of disease or infection.

Health equity arises from access to the social determinants of health, specifically from wealth, power and prestige. Individuals who have consistently been deprived of these three determinants are significantly disadvantaged from health inequities, and face worse health outcomes than those who are able to access certain resources. It is not equity to simply provide every individual with the same resources; that would be equality. In order to achieve health equity, resources must be allocated based on an individual need-based principle.

The social determinants of health are the economic and social conditions that influence individual and group differences in health status. They are the health promoting factors found in one's living and working conditions, rather than individual risk factors that influence the risk for a disease, or vulnerability to disease or injury. The distribution of social determinants is often shaped by public policies that reflect prevailing political ideologies of the area.

The Population Health Forum is a group based at University of Washington in Seattle, Washington, and composed of academics, citizens, students, and activists from around North America.

<span class="mw-page-title-main">Social medicine</span> Understanding how culture and larger groups of people shape health procedures

Social medicine is an interdisciplinary field that focuses on the profound interplay between socio-economic factors and individual health outcomes. Rooted in the challenges of the Industrial Revolution, it seeks to:

  1. Understand how specific social, economic, and environmental conditions directly impact health, disease, and the delivery of medical care.
  2. Promote conditions and interventions that address these determinants, aiming for a healthier and more equitable society.
<span class="mw-page-title-main">Environmental social science</span>

Environmental social science is the broad, transdisciplinary study of interrelations between humans and the natural environment. Environmental social scientists work within and between the fields of anthropology, communication studies, economics, geography, history, political science, psychology, and sociology; and also in the interdisciplinary fields of environmental studies, human ecology and political ecology, social epidemiology, among others.

The Bradford Hill criteria, otherwise known as Hill's criteria for causation, are a group of nine principles that can be useful in establishing epidemiologic evidence of a causal relationship between a presumed cause and an observed effect and have been widely used in public health research. They were established in 1965 by the English epidemiologist Sir Austin Bradford Hill.

<span class="mw-page-title-main">Kate Pickett</span> British epidemiologist

Kate Elizabeth Pickett is a British epidemiologist and political activist who is Professor of Epidemiology in the Department of Health Sciences at the University of York, and was a National Institute for Health and Care Research Career Scientist from 2007 to 2012. She co-authored The Spirit Level: Why More Equal Societies Almost Always Do Better and is a co-founder of The Equality Trust. Pickett was awarded a 2013 Silver Rose Award from Solidar for championing equality and the 2014 Charles Cully Memorial Medal by the Irish Cancer Society.

The social determinants of health in poverty describe the factors that affect impoverished populations' health and health inequality. Inequalities in health stem from the conditions of people's lives, including living conditions, work environment, age, and other social factors, and how these affect people's ability to respond to illness. These conditions are also shaped by political, social, and economic structures. The majority of people around the globe do not meet their potential best health because of a "toxic combination of bad policies, economics, and politics". Daily living conditions work together with these structural drivers to result in the social determinants of health.

Causal inference is the process of determining the independent, actual effect of a particular phenomenon that is a component of a larger system. The main difference between causal inference and inference of association is that causal inference analyzes the response of an effect variable when a cause of the effect variable is changed. The study of why things occur is called etiology, and can be described using the language of scientific causal notation. Causal inference is said to provide the evidence of causality theorized by causal reasoning.

Ecosocial theory, first proposed by name in 1994 by Nancy Krieger of the Harvard T.H. Chan School of Public Health, is a broad and complex theory with the purpose of describing and explaining causal relationships in disease distribution. While it incorporates biological and psychosocial influences on disease occurrence, the theory is also suited to analyze the relationships between social factors and disease development in public health research. The core constructs of Ecosocial Theory are: Embodiment; Pathways to Embodiment; the cumulative interplay between exposure, resistance, and susceptibility; and agency and accountability. Further, the theory specifies that all constructs must be considered in concert, as they work together in a synergistic explanation of disease distribution. The theory assumes that distributions of disease are determined at multiple levels and that analyses must incorporate historical, political economic, temporal, and spatial analyses

Population health, a field which focuses on the improvement of the health outcomes for a group of individuals, has been described as consisting of three components: "health outcomes, patterns of health determinants, and policies and interventions". Policies and Interventions define the methods in which health outcomes and patterns of health determinants are implemented. Policies which are helpful "improve the conditions under which people live". Interventions encourage healthy behaviors for individuals or populations through "program elements or strategies designed to produce behavior changes or improve health status".

Lisa Berkman is an American epidemiologist currently the Thomas D. Cabot Professor of Public Policy, Epidemiology, and Global Health at Harvard T.H. Chan School of Public Health.

<span class="mw-page-title-main">Tyler VanderWeele</span>

Tyler J. VanderWeele is the John L. Loeb and Frances Lehman Loeb Professor of Epidemiology in the Departments of Epidemiology and Biostatistics at the Harvard T.H. Chan School of Public Health. He is also the co-director of Harvard University's Initiative on Health, Religion and Spirituality, the director of their Human Flourishing Program, and a faculty affiliate of the Harvard Institute for Quantitative Social Science. He holds degrees from the University of Oxford, University of Pennsylvania, and Harvard University in mathematics, philosophy, theology, finance, and biostatistics.

Eleanor (Ellie) Jane Murray is a lohan British-Canadian epidemiologist, science communicator, and assistant professor at the Boston University School of Public Health. Throughout the COVID-19 pandemic, Murray created a series of multi-lingual, accessible infographics to communicate information about COVID-19.

<span class="mw-page-title-main">Health politics</span> Interdisciplinary study and analysis of health politics

Health politics or politics of health is an interdisciplinary field of study concerned with the analysis of social and political power over the health status of individuals.

Medellena Maria Lee Glymour is an American epidemiologist. Her primary research interests focus on "how social factors experienced across the lifecourse, such as educational attainment and work environment, influence cognitive function, memory loss, stroke and other health outcomes in old age."

White Americans, as the largest racial group in the United States, have historically had better health outcomes than other oppressed racial groups in America. However, in recent years, the scholarly discourse has switched from recognition of the immense positive health outcomes of white Americans towards understanding the growing persistence of negative outcomes unique to this racial group. Scholars have discussed the effects of racial prejudice and its negative effect on health outcomes to not only those being oppressed but also those being given privileges. In addition to the effects of living in a racialized society, white Americans have the highest rate of suicide and lifetime psychiatric disorders of any other ethnicity or racial category. In conjunction with these psychiatric issues, the population presents higher rates of alcohol usage alongside lower levels of psychological flourishing. Given this information, the health status of white Americans has gained increasing importance due to the differences in health outcomes between white Americans and white people from other parts of the world.

References

  1. ↑ Berkman, Lisa F.; Kawachi, Ichiro (2014). "A Historical Framework for Social Epidemiology: Social Determinants of Population Health". In Berkman, Lisa F.; Kawachi, Ichirō; Glymour, M. Maria (eds.). Social Epidemiology. Oxford University Press. pp. 1–16. ISBN   978-0-19-537790-3.
  2. ↑ Krieger, N (2001). "A glossary for social epidemiology". Journal of Epidemiology & Community Health. 55 (10): 693–700. doi:10.1136/jech.55.10.693. JSTOR   25569537. PMC   1731785 . PMID   11553651.
  3. ↑ Braveman, Paula; Gottlieb, Laura (2014). "The Social Determinants of Health: It's Time to Consider the Causes of the Causes". Public Health Reports. 129 (Suppl 2): 19–31. doi:10.1177/00333549141291S206. JSTOR   23646782. PMC   3863696 . PMID   24385661.
  4. ↑ Diez-Roux, A. V (1998). "Bringing context back into epidemiology: Variables and fallacies in multilevel analysis" (PDF). American Journal of Public Health. 88 (2): 216–22. doi:10.2105/ajph.88.2.216. PMC   1508189 . PMID   9491010.
  5. ↑ Glymour, M. Maria; Rudolph, Kara E (2016). "Causal inference challenges in social epidemiology: Bias, specificity, and imagination". Social Science & Medicine. 166: 258–265. doi:10.1016/j.socscimed.2016.07.045. PMID   27575286.
  6. ↑ Oakes, J.Michael (2004). "The (mis)estimation of neighborhood effects: Causal inference for a practicable social epidemiology". Social Science & Medicine. 58 (10): 1929–52. doi:10.1016/j.socscimed.2003.08.004. PMID   15020009.
  7. ↑ Phelan, Jo C; Link, Bruce G; Tehranifar, Parisa (2010). "Social Conditions as Fundamental Causes of Health Inequalities: Theory, Evidence, and Policy Implications". Journal of Health and Social Behavior. 51: S28–40. doi: 10.1177/0022146510383498 . PMID   20943581.
  8. ↑ Avendano, Mauricio; Kawachi, Ichiro (2014). "Why Do Americans Have Shorter Life Expectancy and Worse Health Than Do People in Other High-Income Countries?". Annual Review of Public Health. 35: 307–25. doi: 10.1146/annurev-publhealth-032013-182411 . PMC   4112220 . PMID   24422560.
  9. 1 2 Nishi, A; Milner, DA Jr; Giovannucci, EL; Nishihara, R; Tan, AS; Kawachi, I; Ogino, S (2016). "Integration of molecular pathology, epidemiology and social science for global precision medicine". Expert Rev Mol Diagn. 16 (1): 11–23. doi:10.1586/14737159.2016.1115346. PMC   4713314 . PMID   26636627.
  10. ↑ Brown, P (1995). "Naming and framing: The social construction of diagnosis and illness". Journal of Health and Social Behavior. Spec No: 34–52. doi:10.2307/2626956. JSTOR   2626956. PMID   7560848.
  11. ↑ Pega, Frank; Kawachi, Ichiro; Rasanathan, Kumanan; Lundberg, Olle (2013). "Politics, policies and population health: a commentary on Mackenbach, Hu and Looman (2013)". Social Science & Medicine. 93: 176–9. doi:10.1016/j.socscimed.2013.06.007. PMID   23850006.
This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.