Structural competency in epidemiological research: What’s feasible, what’s tricky, and the benefits of a ‘structural turn’

Hernáez, Ángel Martínez; Bekele, Deborah

doi:10.1080/17441692.2023.2164903

Cited by 10 publications

(1 citation statement)

References 48 publications

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“…Our findings also suggest a role for a structural competency approach to training across health-related disciplines and practices ( 95 ). Originally conceived to train medical students to better understand and address how structural inequities show up in the clinic, structural competency has been reformulated into a set of guidelines and practices for epidemiologists to introduce epistemic humility into the research process and address paradigmatic challenges of a ‘structural turn’ within the field ( 96 ). Although they do not directly address issues specific to disability and ableism, some social epidemiologists have been advocating for alternatives to positivist epistemological frameworks in the field ( 97 ) to provide a foundation for using qualitative methodologies that can inform deeper and richer explanations of social and health phenomena.…”

Section: Discussionmentioning

confidence: 99%

The study of ableism in population health: a critical review

Mannor,

Needham

2024

Front. Public Health

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Over the past three decades, health equity has become a guiding framework for documenting, explaining, and informing the promotion of population health. With these developments, scholars have widened public health’s aperture, bringing systems of oppression sharply into focus. Additionally, some researchers in disability and health have advocated for utilizing socially grounded frameworks to investigate the health of disabled people. Yet, naming ableism, much less operationalizing it for the empirical study of health, remains scant. This paper critically reviews the study of ableism as a social determinant of disabled people’s health within population health research. First, we provide an orientation to the present state of this literature by looking to the past. We briefly trace a history of traditional approaches to studying disability and health and alternatives that have emerged from critiques of the individualized lens that has dominated this work. Next, we delineate the operation of ableism across social levels. We characterize how ableism has been studied in population health in terms of levels of analysis (intrapersonal, interpersonal, institutional, and structural) and measures of interest. To conclude, we discuss hinderances to and promising avenues toward population health research that advances health equity for disabled people.

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Section: Discussionmentioning

confidence: 99%

The study of ableism in population health: a critical review

Mannor,

Needham

2024

Front. Public Health

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Structuralizing Culture: Multicultural Neoliberalism, Migration, and Mental Health in Santiago, Chile

Abarca-Brown

2024

Cult Med Psychiatry

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The arrival of Afro-descendant migrants, mainly from Haiti and the Dominican Republic, has led to the emergence of new discourses on migration, multiculturalism, and mental health in health services in Chile since 2010. In this article, I explore how mental health institutions, experts, and practitioners have taken a cultural turn in working with migrant communities in this new multicultural scenario. Based on a multisited ethnography conducted over 14 months in a neighbourhood of northern Santiago, I focus on the Migrant Program—a primary health care initiative implemented since 2013. I argue that health practitioners have tended to redefine cultural approaches in structural terms focusing mainly on class aspects such poverty, social stratification, and socioeconomic inequalities. I affirm that this structural-based approach finds its historical roots in a political and ideological context that provided the conditions for the development of community psychiatry experiences during the 1960s and 1970s, as well as in multicultural and gender policies promoted by the state since the 1990s. This case reveals how health institutions and practitioners have recently engaged in debates on migration and intersectionality from a structural approach in Chile.

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