Advancing Health Equity: A Paradigm Shift in Health Research?
The first wave of contemporary health research focused on medicine and the life sciences, with clinical solutions as a primary endpoint. Although such research remains foundational, understanding the social origins of disease—the ‘‘upstream’’ influences on (ill) health and its distribu- tion [6]—generally and almost unavoid- ably falls outside the biomedical frame of
reference. The past few decades have seen
the emergence of a second wave of health research, providing the evidence base for a variety of interventions directed at im- proving the health of populations rather than individuals, with a large component addressing non-communicable diseases.
The work of CSDH underscores the need for more research on how social, political, and economic processes influence health inequities. We consider this grow- ing field of enquiry [7,8] as a paradigm shift and a third, complementary, wave of health research. The new paradigm makes explicit that health systems and the people who use them exist within a social context that can powerfully determine peoples’ chances to be healthy not only through access to health services, but also through access to a range of other resources, opportunities, and rights: the social deter- minants of health. Doing research from this perspective involves re-emphasis of older public health traditions and a push for innovative thinking that incorporates a number of distinct strategies and method- ologies (Box 1).
Research Priorities
Using this frame, we recommend an agenda for research on health equity organized around four distinct yet inter- related areas:
(1) Global Factors and Processes
That Affect Health Equity
‘‘Global health has come to occupy a new and different kind of political space that demands the study of population health in the context of power relations in a world system’’ [9]. Numerous globa
Advancing Health Equity: A Paradigm Shift in Health Research?
The first wave of contemporary health research focused on medicine and the life sciences, with clinical solutions as a primary endpoint. Although such research remains foundational, understanding the social origins of disease—the ‘‘upstream’’ influences on (ill) health and its distribu- tion [6]—generally and almost unavoid- ably falls outside the biomedical frame of
reference. The past few decades have seen
the emergence of a second wave of health research, providing the evidence base for a variety of interventions directed at im- proving the health of populations rather than individuals, with a large component addressing non-communicable diseases.
The work of CSDH underscores the need for more research on how social, political, and economic processes influence health inequities. We consider this grow- ing field of enquiry [7,8] as a paradigm shift and a third, complementary, wave of health research. The new paradigm makes explicit that health systems and the people who use them exist within a social context that can powerfully determine peoples’ chances to be healthy not only through access to health services, but also through access to a range of other resources, opportunities, and rights: the social deter- minants of health. Doing research from this perspective involves re-emphasis of older public health traditions and a push for innovative thinking that incorporates a number of distinct strategies and method- ologies (Box 1).
Research Priorities
Using this frame, we recommend an agenda for research on health equity organized around four distinct yet inter- related areas:
(1) Global Factors and Processes
That Affect Health Equity
‘‘Global health has come to occupy a new and different kind of political space that demands the study of population health in the context of power relations in a world system’’ [9]. Numerous globa
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