Public health developed based on an individualistic biomedical model of health. The field experienced a significant paradigm shift in the 1990s with the widespread adoption of the social ecological model, which incorporated interactions between individuals and their social environments into our understanding of how health is produced. Social determinants grew to be common language for the contexts in which people live, work, worship, learn, play, and age. In the interest of health equity, recognizing determinants outside the control of individuals demanded a focus on those social factors. In the past decade, many public health and social scientists have gone beyond social determinants to recognize and name the role of structural determinants of health—those factors that are the “determinants of the determinants.” These include not only the societal structures that exist, but also the ideologies and systems of power by which they were created and are maintained, such as colonialism, white supremacy, heteropatriarchy, and capitalism.
As global events continuously highlight social and health inequities within communities, municipalities, and society, an understanding of structural determinants calls attention to the role of power in creation of systems, policies, and practices that benefit some groups while enacting violence on others. Oppressive ideologies are enacted by those with power to control the distribution and flow of multiple kinds of resources and capital. Multiple health and social science disciplines are engaged with understanding this phenomenon. But recognizing and acknowledging structural determinants is not enough. If these are the root causes of inequity, influencing them has potential to radically change myriad downstream outcomes. Thus, we must identify key leverage points to change them. One critical leverage point across structures and systems is narrative—the language and stories that are heard, elevated, believed, and acted upon. Language in the field is intentionally changing, to be more person-centered at the individual level (e.g., “minoritized populations” vs. “minorities;” “people experiencing homelessness” vs. “the homeless”), and more focused on who is responsible for issues at higher ecological levels (e.g. “inequities” vs. “disparities;” “structurally marginalized” vs. “disadvantaged” or “at-risk”).
To examine this topic in depth, contributions should consider the significance of language and narrative in defining social and health issues, as these definitions suggest the solutions to those issues. Specific approaches, methods, outcomes, and challenges to changing dominant language and elevating the narratives of structurally marginalized populations are important from which to learn as we develop strategies for intervention in this area. Original research, review articles, and perspectives are welcome as we explore the impact of the use of language and narrative as an enactment of power—a critical force in public health and health equity—particularly regarding problem definition and resource distribution.
This Research Topic welcomes a wide variety of methods, including qualitative and mixed methods approaches, and is open to contributions in the form of original research articles and systematic reviews as well as brief research reports, perspectives, commentaries, mini reviews, policy briefs, and policy and practice reviews.
Public health developed based on an individualistic biomedical model of health. The field experienced a significant paradigm shift in the 1990s with the widespread adoption of the social ecological model, which incorporated interactions between individuals and their social environments into our understanding of how health is produced. Social determinants grew to be common language for the contexts in which people live, work, worship, learn, play, and age. In the interest of health equity, recognizing determinants outside the control of individuals demanded a focus on those social factors. In the past decade, many public health and social scientists have gone beyond social determinants to recognize and name the role of structural determinants of health—those factors that are the “determinants of the determinants.” These include not only the societal structures that exist, but also the ideologies and systems of power by which they were created and are maintained, such as colonialism, white supremacy, heteropatriarchy, and capitalism.
As global events continuously highlight social and health inequities within communities, municipalities, and society, an understanding of structural determinants calls attention to the role of power in creation of systems, policies, and practices that benefit some groups while enacting violence on others. Oppressive ideologies are enacted by those with power to control the distribution and flow of multiple kinds of resources and capital. Multiple health and social science disciplines are engaged with understanding this phenomenon. But recognizing and acknowledging structural determinants is not enough. If these are the root causes of inequity, influencing them has potential to radically change myriad downstream outcomes. Thus, we must identify key leverage points to change them. One critical leverage point across structures and systems is narrative—the language and stories that are heard, elevated, believed, and acted upon. Language in the field is intentionally changing, to be more person-centered at the individual level (e.g., “minoritized populations” vs. “minorities;” “people experiencing homelessness” vs. “the homeless”), and more focused on who is responsible for issues at higher ecological levels (e.g. “inequities” vs. “disparities;” “structurally marginalized” vs. “disadvantaged” or “at-risk”).
To examine this topic in depth, contributions should consider the significance of language and narrative in defining social and health issues, as these definitions suggest the solutions to those issues. Specific approaches, methods, outcomes, and challenges to changing dominant language and elevating the narratives of structurally marginalized populations are important from which to learn as we develop strategies for intervention in this area. Original research, review articles, and perspectives are welcome as we explore the impact of the use of language and narrative as an enactment of power—a critical force in public health and health equity—particularly regarding problem definition and resource distribution.
This Research Topic welcomes a wide variety of methods, including qualitative and mixed methods approaches, and is open to contributions in the form of original research articles and systematic reviews as well as brief research reports, perspectives, commentaries, mini reviews, policy briefs, and policy and practice reviews.
