Paper #4 in our #SERjournalclub is from @sridhartweet and @MichaelMarmot.
The authors introduce a special issue of Bioethics on social determinants of health by framing the philosophical and ethical background, including what do we even mean by "health"
onlinelibrary.wiley.com/doi/abs/10.111…
@sridhartweet @MichaelMarmot In thinking about the ethics of social determinants of health, the authors identify two major philosophical areas that should be explored: (1) the philosophy of epi; and (2) the philosophy of health justice.
Let's dive in!
@sridhartweet @MichaelMarmot What philosophical aspects of epi are important to improving how we think about social determinants of health?
Definitely how we think about and define causation, but also how we define health. Most of our discussion about social determinants are really about *ill-health*.
@sridhartweet @MichaelMarmot From the paper:
"The link between the moral concern for the health of individuals and realizing such concern through epidemiological theory and practice is what establishes epidemiology as being an instrumental science with a moral purpose, and not simply a descriptive science"
The authors argue that epidemiology is inherently driven by a moral purpose.
What moral purpose drives your own research agenda, #epitwitter?
The authors also assert that the current dominant framework for epidemiology is "micro-epidemiology" -- a focus on individual-level causal factors (either in a web of causation or a causal pie), and call for a re-focusing on "macro-epidemiology" -- adding distal social phenomena.
This leads into a discussion of the philosophy of social & health justice.
A question to ponder:
"What is it about health or ill-health that compels a social justice response?"
Types of causes? Absolute levels of health? Relative inequalities? Consequences of ill-health?
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