scholarly journals Counterfactual Theory in Social Epidemiology: Reconciling Analysis and Action for the Social Determinants of Health

2015 ◽  
Vol 2 (1) ◽  
pp. 52-60 ◽  
Author(s):  
Ashley I. Naimi ◽  
Jay S. Kaufman
Author(s):  
Sridhar Venkatapuram

The term health disparities (also called health inequalities) refers to the differences in health outcomes and related events across individuals and social groups. Social determinants of health, meanwhile, refers to certain types of causes of ill health in individuals, including lack of early infant care and stimulation, lack of safe and secure employment, poor housing conditions, discrimination, lack of self-respect, poor personal relationships, low community cohesion, and income inequality. These social determinants stand in contrast to others, such as individual biology, behaviors, and proximate exposures to harmful agents. This chapter presents some of the revolutionary findings of social epidemiology and the science of social determinants of health, and shows how health disparities and social determinants raise profound questions in public health ethics and social/global justice philosophy.


2019 ◽  
Vol 189 (3) ◽  
pp. 175-178 ◽  
Author(s):  
Tyler J VanderWeele

Abstract There are tensions inherent between many of the social exposures examined within social epidemiology and the assumptions embedded in quantitative potential-outcomes-based causal inference framework. The potential-outcomes framework characteristically requires a well-defined hypothetical intervention. As noted by Galea and Hernán (Am J Epidemiol. 2020;189(3):167–170), for many social exposures, such well-defined hypothetical exposures do not exist or there is no consensus on what they might be. Nevertheless, the quantitative potential-outcomes framework can still be useful for the study of some of these social exposures by creative adaptations that 1) redefine the exposure, 2) separate the exposure from the hypothetical intervention, or 3) allow for a distribution of hypothetical interventions. These various approaches and adaptations are reviewed and discussed. However, even these approaches have their limits. For certain important historical and social determinants of health such as social movements or wars, the quantitative potential-outcomes framework with well-defined hypothetical interventions is the wrong tool. Other modes of inquiry are needed.


2019 ◽  
Vol 101 (4) ◽  
pp. 357-395 ◽  
Author(s):  
Saty Satya-Murti ◽  
Jennifer Gutierrez

The Los Angeles Plaza Community Center (PCC), an early twentieth-century Los Angeles community center and clinic, published El Mexicano, a quarterly newsletter, from 1913 to 1925. The newsletter’s reports reveal how the PCC combined walk-in medical visits with broader efforts to address the overall wellness of its attendees. Available records, some with occasional clinical details, reveal the general spectrum of illnesses treated over a twelve-year span. Placed in today’s context, the medical care given at this center was simple and minimal. The social support it provided, however, was multifaceted. The center’s caring extended beyond providing medical attention to helping with education, nutrition, employment, transportation, and moral support. Thus, the social determinants of health (SDH), a prominent concern of present-day public health, was a concept already realized and practiced by these early twentieth-century Los Angeles Plaza community leaders. Such practices, although not yet nominally identified as SDH, had their beginnings in the late nineteenth- and early twentieth-century social activism movement aiming to mitigate the social ills and inequities of emerging industrial nations. The PCC was one of the pioneers in this effort. Its concerns and successes in this area were sophisticated enough to be comparable to our current intentions and aspirations.


Author(s):  
Kristen A. Berg ◽  
Jarrod E. Dalton ◽  
Douglas D. Gunzler ◽  
Claudia J. Coulton ◽  
Darcy A. Freedman ◽  
...  

2007 ◽  
Vol 84 (S1) ◽  
pp. 164-173 ◽  
Author(s):  
Franςoise Barten ◽  
Diana Mitlin ◽  
Catherine Mulholland ◽  
Ana Hardoy ◽  
Ruth Stern

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