Putting health inequities on the map: social epidemiology meets medical/health geography––an ecosocial perspective

Abstract

To put on the map: according to the Oxford English Dictionary, whatever is so placed occupies ''an important or prominent position'' and is ''of some account or importance.'' In this brief commentary, I take the opportunity to reflect on several articles by medical/health geographers and others regarding our Public Health Disparities Geocoding Project and my research, as a social epidemiologist, on the myriad ways racism can harm health. In both cases, my work on these topics has been motivated by my desire, starting a quarter of a century ago, to put health inequities on the map: as a topic of public concern, research, and action. The insightful and informative points and questions raised by the geography-oriented articles underscore the importance of bringing the best of our respective disciplinary insights and expertise to illuminate the profound connections between social justice and public health, between our bodily truths and the body politic, so as to further the goal of embodying equity--in an ecologically sustainable world.

Chlamydia Positivity in Women Screened in Family Planning Clinics: Racial/Ethnic Differences and Trends in the Northwest U.S., 1997–2006

“…[21][22][23][24] Finally, ecological studies have linked social determinants and STI rates. 25,26 Prevalence monitoring programs, including IPP, do not capture data on social determinants, sexual networks, or individuals' SEP. 27 Efforts to measure population-level indicators and integrate them with individual-level STI test records are evolving, but pose complex issues. 16 Measuring individual-and household-level SEP has been challenging, particularly when ascribing class status to adolescents or to women not employed outside the home.…”

The Impact of Binational Barriers to Medical Care on the Care-Seeking Practices of Mexican Immigrants

“…Research into health disparities has sought to locate the “axes of difference” that determine health outcomes and interrogate the ways in which the lived experiences of social categories such as race, socio-economics, and education levels become embodied in differential health outcomes (Krieger, 2009). In recent years, there has been a call to action to complicate our understanding of such differences and recognize the “diversity within diversity,” that gets lost when population health is analyzed without regard to place, nativity, and immigration (Buttenheim et al, 2010; Krieger, 2010; McLafferty & Chakrabarti, 2009).…”

Los determinantes sociales y económicos de la salud. Asuntos teóricos y metodológicos implicados en el análisis

“…El análisis de los determinantes de la salud requiere una teoría epidemiológica que ayude a concatenar los fenómenos sociales, económicos y biológicos que intervienen en los procesos analizados. Un aporte significativo a este propósito es el realizado por la teoría ecosocial, desarrollada desde hace algunos años especialmente por Nancy Krieger (16,(31)(32)(33)(34). Según esta autora, uno de los mayores problemas epistemológicos que resultan cuando se busca ampliar la perspectiva de análisis en los procesos salud-enfermedad, es que con frecuencia se busca refugio en las ciencias sociales, exclusivamente, pero de esta manera se omiten los fenómenos biológicos que subyacen a los procesos de salud-enfermedad.…”