Strategies of Health Promotion Unit 2

https://doi.org/10.1177/2373379920937719

Pedagogy in Health Promotion: The Scholarship of Teaching and Learning 2020, Vol. 6(4) 246 –252 © 2020 Society for Public Health Education Article reuse guidelines: sagepub.com/journals-permissions DOI: 10.1177/2373379920937719 journals.sagepub.com/home/php

Perspectives on Pedagogy

As of December 2018, all schools and programs of public health within the United States are required to be in com- pliance with the 2016 revised accreditation criteria as defined by the Council on Education for Public Health (CEPH; 2016). This includes a number of new educational competencies focused on the relationship among various social phenomena (i.e., social factors) and health. For instance, for both Master of Public Health (MPH) and Doctor of Public Health (DrPH) degree programs, the new 10th, 11th, and 12th “foundational public health knowl- edge” competencies are, “Explain the social, political and economic determinants of health and how they contribute to population health and health inequities,” “Explain how globalization affects global burdens of disease,” and “Explain an ecological perspective on the connections among human health, animal health and ecosystem health,” respectively (CEPH, 2016). Additionally, the sixth “Foundational Competency” states, “Discuss the means by which structural bias, social inequities and racism undermine health and create challenges to achieving health equity at organizational, community and societal levels” (CEPH, 2016).

Competencies calling for the explanation of health- relevant phenomena indicate the need for formal theory. While “theory” is a contested term within the academy

(Abend, 2008), it has been defined in the public health literature as “a set of interrelated concepts, definitions, and propositions that present a systematic view of events or situations by specifying relations among variables, in order to explain and predict the events or situations” (Glanz et al., 2008, p. 26; Kerlinger, 1986, p. 9). According to Krieger (2001), theory helps researchers “explain causal connections between specified phenomena within and across specified domains by using interrelated sets of ideas.” In short, theory plays an explanatory role in public health, organizing concepts and stipulating their relation- ships for the purpose of explaining health-relevant phe- nomena, whether behaviors, economic inequality, or the organization of health care systems.

Social theories of health provide explanations of soci- ety or social phenomena (i.e., racism, globalization, or politics) and their relation to the health of individuals or populations. Given these new educational standards,

937719PHPXXX10.1177/2373379920937719Pedagogy in Health PromotionHarvey research-article2020

1San Jose State University, San Jose, CA, USA

Corresponding Author: Michael Harvey, Department of Health Services Administration and Policy, College of Public Health, Temple University, Bell Building (TECH Center), 3rd Floor, 1101 W. Montgomery Ave., Philadelphia, PA 19122, USA. Email: michael.harvey@temple.edu

How Do We Explain the Social, Political, and Economic Determinants of Health? A Call for the Inclusion of Social Theories of Health Inequality Within U.S.-Based Public Health Pedagogy

Michael Harvey, DrPH1

Abstract New public health educational competencies include the ability to explain social phenomena—such as politics, globalization, and racism—and their relationship to health and disease. Formal explanations of social phenomena call for social theory. However, public health pedagogy is principally concerned with behavioral theory. This piece surveys the behavioral theoretical status quo within public health pedagogy and discusses its implication. The concept of “social theories of health inequality”—that is, explanations of health-relevant social phenomena and their role in producing differences in health, morbidity, and mortality—is proposed as one way of fulfilling new educational competencies. Emerging social theories of health inequality are identified and discussed in relation to public health pedagogy.

Keywords social determinants of health, public health pedagogy, CEPH

Harvey 247

which emphasize explanation of social phenomena and their health effects, one might expect that contemporary public health instruction draws from a broad range of social theories. However, popular public health textbooks and recent research into MPH curricular content suggest that U.S.-based public health pedagogy relies overwhelm- ingly on behavioral theories. For example, M. Harvey and McGladrey’s (2019) analysis of core social and behavioral science course syllabi used within MPH programs found that 93% of commonly taught theories are behavioral.

Popular public health textbooks also attest to the ascendancy of behavioral theory within pedagogy. For example, the index of Public Health 101—the flagship title of Jones and Bartlett’s popular “Essential Public Health” series that is published in partnership with APHA Press—contains a single reference to “theory” (Riegelman & Kirkwood, 2015). The corresponding pages discuss behavioral theories (specifically, the health belief model, transtheoretical model, theory of planned behavior, and social cognitive theory) and one so-called community theory (diffusion of innovations). The titles of other popu- lar public health theory textbooks show the pedagogical import given to health behavior theory within the field: Health Behavior: Theory, Research, and Practice (Glanz et al., 2015); Health Behavior Theory for Public Health: Principles, Foundations, and Applications (DiClemente et al., 2019; copublished with APHA Press); Introduction to Health Behavior Theory (Hayden, 2017); and Essentials of Health Behavior (Edberg, 2018) are just a few exam- ples. It is noteworthy that no analogous Social Theory for Public Health textbook exists. This accords with Goodson’s (2009, Chapter 4) observation regarding the preponderance of intrapersonal behavioral theories within popular public health theory textbooks.

The behavioral status quo within theoretical pedagogy has implications well beyond failing to fulfil accreditation standards. The theories taught within the field shape how its trainees go on to explain, study, and seek to improve population health (Krieger et al., 2010). For example, in the case of the Covid-19 pandemic, employing a com- monly taught health behavior theory like the health belief model might foreground the role of “perceived suscepti- bility” to exposure to the SARS-Cov-2 virus or “perceived severity” of contracting Covid-19 as central to explaining individual behaviors and—by extension—population- level disease dynamics. Research programs based on the health belief model might seek to operationalize and measure these beliefs among individuals in different pop- ulations, and interventions might seek to increase levels of “perceived susceptibility” and “perceived severity” in a particular community. However, this approach is extremely limited, neglecting, for example, the race- and class-based inequalities in Covid-19 infection and mor- tality (Taylor, 2020), or the role of racism, political power, and economic interests in giving rise to and exacerbating

the pandemic (Adams, 2020; Davis, 2020). Without explanations of these phenomena, public health is poorly equipped to address the social, political, and economic drivers of the pandemic—or, worse, health behavior theo- ries can implicitly promote an “ideology of individual responsibility” (McLeroy et  al., 1988, as quoted in Goodson, 2009, p. 100) by treating health inequalities with social or structural origins as arising from the behav- iors, psychology, or lifestyles of individuals.

One might contend that public health is immune to such critique on account of the field’s emphasis on the social determinants of health and the importance of social environments, as discussed in seminal documents like The Ottawa Charter for Health Promotion (World Health Organization, 1986). However, the social deter- minants of health refer to “the conditions in which peo- ple are born, grow, live, work and age” (World Health Organization, n.d.); they provide little theoretical expla- nation for those conditions, their origins, how they are maintained and socially legitimated, or what might be done to change them. Rather, this literature is primarily concerned with empirically documenting the impact of social conditions on health outcomes of individuals and populations. For example, Krieger (2011) notes with regard to the social determinants of health, “Of concern are the health consequences of, say, low income—but not why low income exists” (p. 184). Breilh (2013) fur- ther contends that the social determinants of health lit- erature systematically separates empirically observable social “risk factors” from the social theory that might explain them, thereby obscuring their true origins.

Social Theories of Health Inequality

In order to fulfill newly mandated competencies related to explaining social phenomena and their relationship to health, disease, and health inequalities, public health pedagogy must move beyond its near-exclusive focus on behavioral theory and incorporate social theories of health inequality. Social theories of health inequality are ones that provide explanations of society or health-rele- vant social phenomena and their role in producing dif- ferences in health, morbidity, and mortality. Social theories of health inequality offer explanations of unequal disease burdens that draw on social theory and social scientific literatures concerned with the social determinants of health, disease, and death.

In the context of significant social and health inequal- ities, social theories of health inequality are also “criti- cal” in the sense that social hierarchy, social structure, power, and history are central to their explanations of contemporary health inequalities. They therefore provide a corrective to ahistorical, uncritical, and “desocialized” (Farmer et  al., 2006) theories of health. Rather than individual behavioral or “lifestyle” interventions, these

248 Pedagogy in Health Promotion 6(4)

theories often call for “structural” (Blankenship et  al., 2006) and “fundamental” interventions (Reich et  al., 2016) into the social world to address health-relevant phenomena, such as policies that create and maintain income and wealth inequality, forms of racism and racial inequality, and inequitable health care, educational, judicial, carceral, political, and economic systems. Social theories of health inequality are related to what have previously been described as “models of health inequality” (Bartley, 2016), “epidemiologic theory” (Krieger, 2014; Krieger & Zierler, 1996), and “theories of disease causality” (Tesh, 1988).

While a broadly identifiable corpus of commonly used behavioral theories already exists within public health (cf. Davis et  al., 2015; Glanz et  al., 2015; M. Harvey & McGladrey, 2019), there is no such corpus for social theories. However, recent innovations in public health theory provide some promising candidates. The first is fundamental cause theory, which attempts to explain the social gradient in health, a foundational empirical concept within public health (Link & Phelan, 1995; Phelan et  al., 2010). Fundamental cause theory has been taken up widely within the public health litera- ture (cf. Bränström et al., 2016; Mackenbach et al., 2015; Polonijo & Carpiano, 2013; Rubin et al., 2014; Saldana- Ruiz et  al., 2012). The second is structural violence, which seeks to explain social structures, a core socio- logical concept, and the harmful role they can play in producing avoidable harm and suffering (Farmer, 2004; Farmer et al., 2006; Galtung & Höivik, 1971). De Maio and Ansell (2018) show that structural violence is increas- ingly being incorporated within health science literature to explain the harms produced by a wide range of social phenomena, such as gender inequality, poverty, and his- torical trauma. Third, the political economy of health provides a theoretical framework for explaining the rela- tionship among political economic systems, class struc- ture, political power, and the unequal distribution of morbidity and mortality (Doyal & Pennell, 1979; Minkler et  al., 1994; Navarro, 1976a). Various notable critical public health scholars have incorporated the political economy of health in their respective analyses of health inequality (cf. Bambra, 2011; Birn et  al., 2009, 2017; Krieger, 2011; Waitzkin, 2015). Finally, critical race the- ory represents an academic movement committed to racial equity that incorporates a broad set of theories, concepts, and methodologies (Delgado & Stefancic, 2017; Willis, 2008). Within the past decade, critical race theory, which originated in legal studies, has become increasingly prominent within the public health litera- ture (cf. Ford & Airhihenbuwa, 2010, 2018; Ford et al., 2019; Gilbert & Ray, 2016; Graham et al., 2011).

Additional theories might also inform a new social theo- retical public health corpus. These include stigma theory (Link & Phelan, 2001), stigma power (Link & Phelan,

2014), and structural stigma (Hatzenbuehler, 2018), life course theory (Braveman & Barclay, 2009; Pearlin et  al., 2005), minority stress theory (Meyer, 1995), intersectional- ity (Bowleg, 2012; Crenshaw, 1991, racism (Gilmore, 2007; Jones, 2000), racialization (Omi & Winant, 2014), structural racism (Bailey et al., 2017), the theory of gender and power (Wingood & DiClemente, 2000), structural vul- nerability (Quesada et  al., 2011), theories of risk (Beck, 1992; Lupton, 1999), everyday violence (Bourgois et  al., 2004; Scheper-Hughes, 1993), the violence continuum (Bourgois, 2001), weathering and allostatic load (Geronimus et al., 2006), biopolitics and governmentality (Crawshaw, 2012; Lemke, 2001), theories of social capital (Kawachi et  al., 2008; Szreter & Woolcock, 2004), Bourdieu’s theories of habitus, field, doxa, symbolic power, symbolic violence, and symbolic capital (Grenfell, 2014), theories of ideology (Eagleton, 2007), naturalized inequal- ity (Holmes, 2013), and hegemony (Gramsci, 1971/1989), systems theory (Elkins & Gorman, 2016), syndemic theory (Mendenhall, 2017; Singer & Clair, 2003), ecosocial the- ory (Krieger, 2014), embodiment (Krieger, 2005), medical- ization (Conrad, 1992; Crawford, 1980), social construction (Conrad & Barker, 2010; Fassin, 2004), social practice theory (Crawford, 2006), theories of development, under- development, and dependency (Navarro, 1976a, 1976b; Peet & Hartwick, 2015), neoliberalism (D. Harvey, 2007; Keshavjee, 2014), dialectical critical realism (Scambler & Scambler, 2015), social determination (Breilh Paz y Miño, 2010), and the health-disease-care process (Laurell, 1986).

Moving forward, a standard corpus of social theories, models, concepts, and frameworks useful for explaining and addressing the social phenomena that create health inequality is needed for informing pedagogy. With this corpus, educators could develop curricula and assess student responsiveness. Work is currently under way by the author and colleagues to assess students’ perceived relevance of social theories of health inequality to their future careers and to their ability to address those inequalities. Additionally, the emerging structural com- petency literature, which describes a new, theory-driven, pedagogical framework for training health care profes- sionals to recognize and respond to disease and its unequal distribution as the outcome of social structures, such as inequitable systems, policies, and institutions (Metzl & Hansen, 2014; Neff et  al., 2017; Neff et  al., 2019; Neff et al., 2020), might also inform these peda- gogical changes. Finally, assessment of the impact of this instruction on subsequent public health research and practice undertaken by graduates—and ultimately on levels of health inequality—is also needed. The adoption of social theories of health inequality across public health degree programs has the potential to not only ful- fill newly mandated competencies but also renew theo- retical public health instruction for a new generation of

Harvey 249

students seeking to address the social drivers of health inequities.

Author’s Note

Michael Harvey is now at Temple University in the College of Public Health and Department of Health Services Administration and Policy.

Declaration of Conflicting Interests

The author declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author received no financial support for the research, authorship, and/or publication of this article.

ORCID iD

Michael Harvey https://orcid.org/0000-0003-2341-1980

References

Abend, G. (2008). The meaning of “theory.” Sociological Theory, 26(2), 173–199. https://doi.org/10.1111/j.1467- 9558.2008.00324.x

Adams, V. (2020, March 26). Disasters and capitalism . . . and COVID-19. Somatosphere. http://somatosphere.net/2020/ disaster-capitalism-covid19.html/

Bailey, Z. D., Krieger, N., Agénor, M., Graves, J., Linos, N., & Bassett, M. T. (2017). Structural racism and health inequi- ties in the USA: evidence and interventions. The Lancet, 389(10077), 1453–1463. https://doi.org/10.1016/S0140- 6736(17)30569-X

Bambra, C. (2011). Work, worklessness, and the political econ- omy of health. Oxford University Press.

Bartley, M. (2016). Health inequality: An introduction to con- cepts, theories and methods. John Wiley.

Beck, U. (1992). Risk society: Towards a new modernity. Sage. Birn, A.-E., Pillay, Y., & Holtz, T. (2009). Textbook of interna-

tional health: Global health in a dynamic world. Oxford University Press.

Birn, A.-E., Pillay, Y., & Holtz, T. (2017). Textbook of global health (4th ed.). Oxford University Press.

Blankenship, K. M., Friedman, S. R., Dworkin, S., & Mantell, J. E. (2006). Structural interventions: Concepts, challenges and opportunities for research. Journal of Urban Health, 83(1), 59–72. https://doi.org/10.1007/s11524-005-9007-4

Bourgois, P. (2001). The power of violence in war and peace: Post-Cold War lessons from El Salvador. Ethnography, 2(1), 5–34. https://doi.org/10.1177/14661380122230803

Bourgois, P., Prince, B., & Moss, A. (2004). The everyday vio- lence of hepatitis C among young women who inject drugs in San Francisco. Human Organization, 63(3), 253–264. https://doi.org/10.17730/humo.63.3.h1phxbhrb7m4mlv0

Bowleg, L. (2012). The problem with the phrase women and minorities: Intersectionality—An important theoretical framework for public health. American Journal of Public

Health, 102(7), 1267–1273. https://doi.org/10.2105/ AJPH.2012.300750

Bränström, R., Hatzenbuehler, M. L., Pachankis, J. E., & Link, B. G. (2016). Sexual orientation disparities in prevent- able disease: A fundamental cause perspective. American Journal of Public Health, 106(6), 1109–1115. https://doi. org/10.2105/AJPH.2016.303051

Braveman, P., & Barclay, C. (2009). Health disparities begin- ning in childhood: A life-course perspective. Pediatrics, 124(Suppl.) 3, S163-S175. https://doi.org/10.1542/ peds.2009-1100D

Breilh, J. (2013). La determinación social de la salud como her- ramienta de transformación hacia una nueva salud pública (salud colectiva) [The social determination of health as a tool of transformation towards a new public health (collec- tive health)]. Revista Facultad Nacional de Salud Pública, 31, 13–27.

Breilh Paz y Miño, J. (2010). Epidemiología: Economía política y salud, bases estructurales de la determinación social de la salud [Epidemiology: Political economy and health, struc- tural bases of the social determination of health] (7th ed.). Corporación Editora Nacional.

Conrad, P. (1992). Medicalization and social control. Annual Review of Sociology, 18(1), 209–232. https://doi. org/10.1146/annurev.so.18.080192.001233

Conrad, P., & Barker, K. K. (2010). The social construction of illness: Key insights and policy implications. Journal of Health and Social Behavior, 51(1 Suppl.), S67–S79. https:// doi.org/10.1177/0022146510383495

Council on Education for Public Health. (2016). Accreditation criteria. https://media.ceph.org/wp_assets/2016.Criteria. pdf

Crawford, R. (1980). Healthism and the medicalization of everyday life. International Journal of Health Services, 10(3), 365–388. https://doi.org/10.2190/3H2H-3XJN- 3KAY-G9NY

Crawford, R. (2006). Health as a meaningful social practice. Health, 10(4), 401–420. https://doi.org/10.1177/1363459306067310

Crawshaw, P. (2012). Governing at a distance: Social market- ing and the (bio) politics of responsibility. Social Science & Medicine, 75(1), 200–207. https://doi.org/10.1016/j.socs- cimed.2012.02.040

Crenshaw, K. (1991). Mapping the margins: Intersectionality, identity politics, and violence against women of color. Stanford Law Review, 43(6), 1241–1299. https://doi. org/10.2307/1229039

Davis, M. (2020). The monster enters. New Left Review, p. 122. https://newleftreview.org/issues/II122/articles/mike-davis- in-a-plague-year

Davis, R., Campbell, R., Hildon, Z., Hobbs, L., & Michie, S. (2015). Theories of behaviour and behaviour change across the social and behavioural sciences: A scoping review. Health Psychology Review, 9(3), 323–344. https:// doi.org/10.1080/17437199.2014.941722

De Maio, F., & Ansell, D. (2018). “As natural as the air around us”: On the origin and development of the con- cept of structural violence in health research. International Journal of Health Services, 48(4), 749–759. https://doi. org/10.1177/0020731418792825

250 Pedagogy in Health Promotion 6(4)

Delgado, R., & Stefancic, J. (2017). Critical race theory: An introduction (3rd ed.). NYU Press.

DiClemente, R. J., Salazar, L. F., & Crosby, R. A. (2019). Health behavior theory for public health. Jones & Bartlett Learning.

Doyal, L., & Pennell, I. (1979). The political economy of health. Pluto Press.

Eagleton, T. (2007). Ideology: An introduction. Verso. Edberg, M. (2018). Essentials of health behavior (3rd ed.). Jones

& Bartlett Learning. Elkins, A., & Gorman, D. (2016). Systems theory in public

health. Oxford Bibliographies. https://www.oxfordbibliog- raphies.com/view/document/obo-9780199756797/obo- 9780199756797-0072.xml

Farmer, P. (2004). An anthropology of structural violence. Current Anthropology, 45(3), 305–325. https://doi. org/10.1086/382250

Farmer, P. E., Nizeye, B., Stulac, S., & Keshavjee, S. (2006). Structural violence and clinical medicine. PLOS Medicine, 3(10), e449. https://doi.org/10.1371/journal.pmed.0030449

Fassin, D. (2004). Public health as culture. The social con- struction of the childhood lead poisoning epidemic in France. British Medical Bulletin, 69(1), 167–177. https:// doi.org/10.1093/bmb/ldh017

Ford, C., Griffith, D., Bruce, M., & Gilbert, K. (2019). Racism: Science & tools for the public health professional (1st ed.). American Public Health Association.

Ford, C. L., & Airhihenbuwa, C. O. (2010). The public health critical race methodology: Praxis for antiracism research. Social Science & Medicine, 71(8), 1390–1398. https://doi. org/10.1016/j.socscimed.2010.07.030

Ford, C. L., & Airhihenbuwa, C. O. (2018). Commentary: Just what is critical race theory and what’s it doing in a progres- sive field like public health? Ethnicity & Disease, 28(Suppl. 1), 223–230. https://doi.org/10.18865/ed.28.S1.223

Galtung, J., & Höivik, T. (1971). Structural and direct violence: A note on operationalization. Journal of Peace Research, 8(1), 73–76. https://doi.org/10.1177/002234337100800108

Geronimus, A. T., Hicken, M., Keene, D., & Bound, J. (2006). “Weathering” and age patterns of allostatic load scores among blacks and whites in the United States. American Journal of Public Health, 96(5), 826–833. https://doi. org/10.2105/AJPH.2004.060749

Gilbert, K. L., & Ray, R. (2016). Why police kill black males with impunity: Applying public health critical race praxis (PHCRP) to address the determinants of policing behaviors and “Justifiable” homicides in the USA. Journal of Urban Health, 93(1), 122–140. https://doi.org/10.1007/s11524- 015-0005-x

Gilmore, R. W. (2007). Golden gulag: Prisons, surplus, cri- sis, and opposition in globalizing California (Vol. 21). University of California Press.

Glanz, K., Rimer, B. K., & Viswanath, K. (2008). Health behav- ior and health education: Theory, research, and practice. John Wiley.

Glanz, K., Rimer, B. K., & Viswanath, K. (2015). Health behav- ior: Theory, research, and practice. John Wiley.

Goodson, P. (2009). Theory in health promotion research and practice: Thinking outside the box (1st ed.). Jones & Bartlett Learning.

Graham, L., Brown-Jeffy, S., Aronson, R., & Stephens, C. (2011). Critical race theory as theoretical framework and analysis tool for population health research. Critical Public Health, 21(1), 81–93. https://doi.org/10.1080/09581596.2 010.493173

Gramsci, A. (1989). Selections from the prison notebooks. International (Reprinted from Selections from the prison notebooks, by Q. Hoare & G. N. Smith, Eds., 1971, Lawrence & Wishart).

Grenfell, M. (Ed.). (2014). Pierre Bourdieu: Key concepts (2nd ed.). Routledge.

Harvey, D. (2007). A brief history of neoliberalism. Oxford University Press.

Harvey, M., & McGladrey, M. (2019). Explaining the origins and distribution of health and disease: An analysis of epi- demiologic theory in core master of public health course- work in the United States. Critical Public Health, 29(1), 5–17. https://doi.org/10.1080/09581596.2018.1535698

Hatzenbuehler, M. L. (2018). Structural stigma and health. https://doi.org/10.1093/oxfordhb/9780190243470.013.13

Hayden, J. (2017). Introduction to health behavior theory. Jones & Bartlett Learning.

Holmes, S. (2013). Fresh fruit, broken bodies: Migrant farmwork- ers in the United States (1st ed.). University of California Press. https://www.jstor.org/stable/10.1525/j.ctt7zw45x

Jones, C. P. (2000). Levels of racism: A theoretic framework and a gardener’s tale. American Journal of Public Health, 90(8), 1212–1215. https://doi.org/10.2105/AJPH.90.8.1212

Kawachi, I., Subramanian, S. V., & Kim, D. (2008). Social cap- ital and health. In I. Kawachi, S. V. Subramanian, & D. Kim (Eds.), Social capital and health (pp. 1–26). Springer. https://doi.org/10.1007/978-0-387-71311-3_1

Kerlinger, F. N. (1986). Foundations of behavioral research. Holt, Rinehart & Winston.

Keshavjee, S. (2014). Blind spot: How neoliberalism infiltrated global health. University of California Press.

Krieger, N. (2001). Theories for social epidemiology in the 21st century: An ecosocial perspective. International Journal of Epidemiology, 30(4), 668–677. https://doi.org/10.1093/ ije/30.4.668

Krieger, N. (2005). Embodiment: A conceptual glossary for epi- demiology. Journal of Epidemiology & Community Health, 59(5), 350–355. https://doi.org/10.1136/jech.2004.024562

Krieger, N. (2011). Epidemiology and the people’s health: Theory and context (1st ed.). Oxford University Press.

Krieger, N. (2014). Got theory? On the 21st c. CE rise of explicit use of epidemiologic theories of disease distribution: A review and ecosocial analysis. Current Epidemiology Reports, 1(1), 45–56. https://doi.org/10.1007/s40471-013- 0001-1

Krieger, N., Alegría, M., Almeida-Filho, N., Silva, J. B. da, Barreto, M. L., Beckfield, J., Berkman, L., Birn, A.-E., Duncan, B. B., Franco, S., Garcia, D. A., Gruskin, S., James, S. A., Laurell, A. C., Schmidt, M. I., & Walters, K. L. (2010). Who, and what, causes health inequities? Reflections on emerging debates from an exploratory Latin American/North American workshop. Journal of Epidemiology & Community Health, 64(9), 747–749. https://doi.org/10.1136/jech.2009.106906

Harvey 251

Krieger, N., & Zierler, S. (1996). What explains the public’s health? A call for epidemiologic theory. Epidemiology, 7(1), 107–109. https://doi.org/10.1097/00001648-199601000- 00020

Laurell, A. C. (1986). El estudio social del proceso salud-enfer- medad en América Latina [The social study of the health- disease process in Latin America]. Cuadernos Médico Sociales, 37, 3–18.

Lemke, T. (2001). “The birth of bio-politics”: Michel Foucault’s lecture at the Collège de France on neo-liberal governmen- tality. Economy and Society, 30(2), 190–207. https://doi. org/10.1080/03085140120042271

Link, B. G., & Phelan, J. (1995). Social conditions as fundamen- tal causes of disease. Journal of Health and Social Behavior, 80–94. https://doi.org/10.2307/2626958

Link, B. G., & Phelan, J. C. (2001). Conceptualizing stigma. Annual Review of Sociology, 27(1), 363–385. https://doi. org/10.1146/annurev.soc.27.1.363

Link, B. G., & Phelan, J. (2014). Stigma power. Social Science & Medicine, 103, 24–32. https://doi.org/10.1016/j.socs- cimed.2013.07.035

Lupton, D. (1999). Risk and sociocultural theory: New direc- tions and perspectives. Cambridge University Press.

Mackenbach, J. P., Kulhánová, I., Bopp, M., Deboosere, P., Eikemo, T. A., Hoffmann, R., Kulik, M. C., Leinsalu, M., Martikainen, P., Menvielle, G., Regidor, E., Wojtyniak, B., Östergren, O., & Lundberg, O. (2015). Variations in the relation between education and cause-specific mortal- ity in 19 European populations: A test of the “fundamen- tal causes” theory of social inequalities in health. Social Science & Medicine, 127, 51–62. https://doi.org/10.1016/j. socscimed.2014.05.021

Mendenhall, E. (2017). Syndemics: A new path for global health research. The Lancet, 389(10072), 889–891. https:// doi.org/10.1016/S0140-6736(17)30602-5

Metzl, J. M., & Hansen, H. (2014). Structural competency: Theorizing a new medical engagement with stigma and inequality. Social Science & Medicine, 103, 126–133. https://doi.org/10.1016/j.socscimed.2013.06.032

Meyer, I. H. (1995). Minority stress and mental health in gay men. Journal of Health and Social Behavior, 36(1), 38–56. JSTOR. https://doi.org/10.2307/2137286

Minkler, M., Wallace, S. P., & McDonald, M. (1994). The polit- ical economy of health: A useful theoretical tool for health education practice. International Quarterly of Community Health Education, 15(2), 111–125. https://doi.org/10.2190/ T1Y0-8ARU-RL96-LPDU

Navarro, V. (1976a). Medicine under capitalism. Prodist. Navarro, V. (1976b). The underdevelopment of health of work-

ing America: Causes, consequences and possible solu- tions. American Journal of Public Health, 66(6), 538–547. https://doi.org/10.2105/AJPH.66.6.538

Neff, J., Holmes, S., Knight, K., Strong, S., Thompson-Lastad, A., McGuinness, C., Duncan, L., Saxena, N., Harvey, M., Langford, A., Carey-Simms, K., Minahan, S., Satterwhite, S., Ruppel, C., Lee, S., Walkover, L., Avila, J. D., Lewis, B., Matthews, J., & Nelson, N. (2020). Structural competency: Curriculum for medical students, residents, and interpro- fessional teams on the structural factors that produce health

disparities. MedEdPORTAL, 16. Advance online publica- tion. https://doi.org/10.15766/mep_2374-8265.10888

Neff, J., Holmes, S. M., Strong, S., Chin, G., De Avila, J., Dubal, S., Duncan, L. G., Halpern, J., Harvey, M., Knight, K. R., Lemay, E., Lewis, B., Matthews, J., Nelson, N., Satterwhite, S., Thompson-Lastad, A., & Walkover, L. (2019). The structural competency working group: Lessons from iterative, interdisci- plinary development of a structural competency training mod- ule. In H. Hansen & J. M. Metzl (Eds.), Structural competency in mental health and medicine: A case-based approach to treating the social determinants of health (pp. 53–74). Springer International. https://doi.org/10.1007/978-3-030-10525-9_5

Neff, J., Knight, K. R., Satterwhite, S., Nelson, N., Matthews, J., & Holmes, S. M. (2017). Teaching structure: A qualitative evaluation of a structural competency training for resident physicians. Journal of General Internal Medicine, 32(4), 430–433. https://doi.org/10.1007/s11606-016-3924-7

Omi, M., & Winant, H. (2014). Racial formation in the United States. Routledge.

Pearlin, L. I., Schieman, S., Fazio, E. M., & Meersman, S. C. (2005). Stress, health, and the life course: Some conceptual perspectives. Journal of Health and Social Behavior, 46(2), 205–219. https://doi.org/10.1177/002214650504600206

Peet, R., & Hartwick, E. (2015). Theories of development: Contentions, arguments, alternatives (3rd ed.). Guilford Press.

Phelan, J. C., Link, B. G., & Tehranifar, P. (2010). Social condi- tions as fundamental causes of health inequalities: Theory, evidence, and policy implications. Journal of Health and Social Behavior, 51(1 Suppl.), S28–S40. https://doi. org/10.1177/0022146510383498

Polonijo, A. N., & Carpiano, R. M. (2013). Social inequali- ties in adolescent human papillomavirus (HPV) vaccina- tion: A test of fundamental cause theory. Social Science & Medicine, 82, 115–125. https://doi.org/10.1016/j.socs- cimed.2012.12.020

Quesada, J., Hart, L. K., & Bourgois, P. (2011). Structural vul- nerability and health: Latino migrant laborers in the United States. Medical Anthropology, 30(4), 339–362. https://doi. org/10.1080/01459740.2011.576725

Reich, A. D., Hansen, H. B., & Link, B. G. (2016). Fundamental interventions: How clinicians can address the fundamen- tal causes of disease. Journal of Bioethical Inquiry, 13(2), 185–192. https://doi.org/10.1007/s11673-016-9715-3

Riegelman, R., & Kirkwood, B. (2015). Public health 101: Healthy people-healthy populations (2nd ed.). Jones & Bartlett.

Rubin, M. S., Clouston, S., & Link, B. G. (2014). A fundamental cause approach to the study of disparities in lung cancer and pancreatic cancer mortality in the United States. Social Science & Medicine, 100, 54–61. https://doi.org/10.1016/j. socscimed.2013.10.026

Saldana-Ruiz, N., Clouston, S. A. P., Rubin, M. S., Colen, C. G., & Link, B. G. (2012). Fundamental causes of colorectal cancer mortality in the United States: Understanding the importance of socioeconomic status in creating inequal- ity in mortality. American Journal of Public Health, 103(1), 99–104. https://doi.org/10.2105/AJPH.2012.300743

Scambler, G., & Scambler, S. (2015). Theorizing health inequalities: The untapped potential of dialectical critical

252 Pedagogy in Health Promotion 6(4)

realism. Social Theory & Health, 13(3), 340–354. https:// doi.org/10.1057/sth.2015.14

Scheper-Hughes, N. (1993). Death without weeping: The vio- lence of everyday life in Brazil. University of California Press.

Singer, M., & Clair, S. (2003). Syndemics and public health: Reconceptualizing disease in bio-social context. Medical Anthropology Quarterly, 17(4), 423–441. https://doi. org/10.1525/maq.2003.17.4.423

Szreter, S., & Woolcock, M. (2004). Health by association? Social capital, social theory, and the political economy of public health. International Journal of Epidemiology, 33(4), 650–667. https://doi.org/10.1093/ije/dyh013

Taylor, K.-Y. (2020, April 16). The Black Plague. The New Yorker. https://www.newyorker.com/news/our-columnists/ the-black-plague

Tesh, S. N. (1988). Hidden arguments: Political ideology and disease prevention policy. Rutgers University Press.

Waitzkin, H. (2015). Medicine and public health at the end of empire. Routledge.

World Health Organization. (n.d.). About social determinants of health. http://www.who.int/social_determinants/sdh_ definition/en/

World Health Organization. (1986, November 21). The Ottawa Charter for Health Promotion. http://www.who.int/health- promotion/conferences/previous/ottawa/en/

Willis, A. I. (2008). Critical race theory. In N. H. Hornberger (Ed.), Encyclopedia of language and education (pp. 432– 445). Springer. https://doi.org/10.1007/978-0-387-30424- 3_32

Wingood, G. M., & DiClemente, R. J. (2000). Application of the theory of gender and power to examine HIV-related expo- sures, risk factors, and effective interventions for women. Health Education & Behavior, 27(5), 539–565. https://doi. org/10.1177/109019810002700502

Copyright of Pedagogy in Health Promotion is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.