Justice, Evidence, and Interdisciplinary Health Inequalities Research

2016 ◽  
Author(s):  
Nicholas B. King
Keyword(s):  
Social Determinants Of Health ◽  
Health Inequalities ◽  
Social Determinants ◽  
Economic Resources ◽  
Determinants Of Health ◽  
Counterfactual Reasoning ◽  
Normative Judgment ◽  
Scientific Investigations ◽  
The Social

This chapter examines the interplay between normative judgments and empirical research. Using a case study of recent work on the social determinants of health, the author argues that three domains that are normally thought of as conceptually and disciplinarily independent—epistemology, scientific methodology, and normative judgment—are in fact closely intertwined. When considering issues related to health inequalities and social justice, keeping these domains separate leads to poor science, poor theorizing, and, ultimately, poor policy choices. The author identifies three problems with the claim that in order to reduce health inequalities and improve population health, we are morally compelled to address the social determinants of health, through interventions that redistribute social or economic resources in a more fair or just manner. The problems are (1) assuming that data are the neutral products of objective scientific investigations; (2) misunderstanding causality and counterfactual reasoning; and (3) blind belief in the consonance of the good.

scholarly journals Exploring the local policy context for reducing health inequalities in children and young people: an in depth qualitative case study of one local authority in the North of England, UK

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Eleanor Holding ◽  
Hannah Fairbrother ◽  
Naomi Griffin ◽  
Jonathan Wistow ◽  
Katie Powell ◽  
...  
Keyword(s):  
Child Health ◽  
Social Determinants Of Health ◽  
Health Inequalities ◽  
Social Determinants ◽  
Qualitative Case Study ◽  
Determinants Of Health ◽  
Local Policy ◽  
Inequalities In Health ◽  
The North

Abstract Background Improving children and young people’s (CYP) health and addressing health inequalities are international priorities. Reducing inequalities is particularly pertinent in light of the Covid-19 outbreak which has exacerbated already widening inequalities in health. This study aimed to explore understandings of inequality, the anticipated pathways for reducing inequalities among CYP and key factors affecting the development and implementation of policy to reduce inequalities among CYP at a local level. Methods We carried out a qualitative case study of one local government region in the North of England (UK), comprising semi structured interviews (n = 16) with service providers with a responsibility for child health, non-participant observations of key meetings (n = 6 with 43 participants) where decisions around child health are made, and a local policy documentation review (n = 11). We employed a novel theoretical framework, drawing together different approaches to understanding policy, to guide our design and analysis. Results Participants in our study understood inequalities in CYP health almost exclusively as socioeconomically patterned inequalities in health practices and outcomes. Strategies which participants perceived to reduce inequalities included: preventive support and early intervention, an early years/whole family focus, targeted working in local areas of high deprivation, organisational integration and whole system/place-based approaches. Despite demonstrating a commitment to a social determinants of health approach, efforts to reduce inequalities were described as thwarted by the prevalence of poverty and budget cuts which hindered the ability of local organisations to work together. Participants critiqued national policy which aimed to reduce inequalities in CYP health for failing to recognise local economic disparities and the interrelated nature of the determinants of health. Conclusions Despite increased calls for a ‘whole systems’ approach to reducing inequalities in health, significant barriers to implementation remain. National governments need to work towards more joined up policy making, which takes into consideration regional disparities, allows for flexibility in interpretation and addresses the different and interrelated social determinants of health. Our findings have particular significance in light of Covid-19 and indicate the need for systems level policy responses and a health in all policies approach.

scholarly journals 21.I. Round table: Comparing and designing the politics and policies for better economic and social welfare

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
◽  
Keyword(s):  
Social Welfare ◽  
Social Determinants Of Health ◽  
Health Inequalities ◽  
Social Determinants ◽  
Determinants Of Health ◽  
Recent Book ◽  
The Political ◽  
Western Countries ◽  
The Social ◽  
The Uk

Abstract While the political and social determinants of health have become accepted among academic researchers, health inequalities in the health policy and political arenas are still predominantly addressed as outcomes of citizens' lifestyle and behavioural choices. The rise of populist radical parties across Western countries brings renewed urgency to communicating with elected leaders and policy makers about the importance of tackling the social (as well as behavioral and medical) determinants of health. Recent publications such as 'Health in Hard Times. Austerity and Health Inequalities' (Clare Bambra, 2019) and 'Health Equity in England: The Marmot Review 10 Years On' (Marmot et al, 2020) find that financial and economic policies in large part contribute to stagnating and even reversing population health trends in the UK and across Western countries. The underlying political system of decision-making needs to be clarified in order to effectively engage and exert influence. This workshop aims to strengthen countervailing power and competence in understanding the policy trajectories that effectively target the larger ambitions of economic and social welfare including reduced health inequalities. We provide participants with basic knowledge, methods and tools to carry out practice-based comparative analysis of public health politics and policies across different countries. The workshop consists of: A 20-minute mini-lecture by Julia Lynch, who will present key findings and the underlying methodology of her recent book Regimes of inequality: The political economy of health and wealth. This book systematically used historical institutionalist-methods and process tracing to compare the policies and politics aimed at reducing health inequalities in Finland, France and the UK from the 1990s to the present.A 15-minute panel reflection: The panel, consisting of Clare Bambra, Karien Stronks, and Holly Jarman, will relate this to their own key research and impact.A 25-minute plenary discussion of examples, questions and contributions to tackling inequalities in political and social determinants of health. Examples are labour market participation policies, progressive fiscal policies or policies resolving illiteracy or household financial debt. Key messages Health inequalities are a political choice. Learning by comparison increases capacity to improve policies on the social determinants of health as well as capacity to increase political influence.

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