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Producing More Relevant Evidence: Applying a Social Epidemiology Research Agenda to Public Health Practice

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Abstract

To date, social epidemiology research has largely been restricted to the description of health disparities and their association with social gradients. Rarely do social epidemiologists expand upon these general-level associations and begin to examine the causal pathways linking social disparities to health. This research approach presents numerous challenges for public health practitioners who attempt to integrate social epidemiology research into policies and programs, as intervention on the identified social gradients is difficult and may divert efforts from more productive options. Furthermore, social epidemiology research is seldom accessible to public health practitioners in a form that is applicable to practice and adaptable to the local context. In order to generate research that can be translated into action to improve health, social epidemiology must progress from providing descriptions at the general level and begin to understand mechanisms leading to health outcomes. The purpose of this chapter is to discuss how social epidemiologists can produce such evidence and ensure that their research is more relevant to public health policy and practice. This chapter will also examine the challenges associated with integrating social epidemiology research into practice and offer guidance for how a social epidemiology research agenda can be implemented.

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Abbreviations

CHSRF:

Canadian Health Services Research Foundation

CIHR:

Canadian Institutes of Health Research

SGA:

small for gestational age

References

  • Al-Jewair TS, Leake JL (2010) The prevalence and risks of early childhood caries (ECC) in Toronto, Canada. J Contemp Dent Pract 11:1–8

    Google Scholar 

  • Bhopal R (2008) Causes in epidemiology: the jewels in the public health crown. J Public Health 30:224–225

    Article  Google Scholar 

  • Centres for Disease Control and Prevention (2011) Community water fluorination. http://www.cdc.gov/fluoridation/. Accessed 31 Jan 2011

  • Davis SK, Winkleby MA, Farquhar JW (1995) Increasing disparity in knowledge of cardiovascular disease risk factors and risk-reduction strategies by socioeconomic status: implications for policymakers. Am J Prev Med 11:318–323

    PubMed  CAS  Google Scholar 

  • Dunn JR (2010) Health behavior vs the stress of low socioeconomic status and health outcomes. JAMA 303:1199–1200

    Article  PubMed  CAS  Google Scholar 

  • Edelstein BL (2002) Disparities in oral health and access to care: findings of national surveys. Ambul Pediatr 2:141–147

    Article  PubMed  Google Scholar 

  • Edelstein BL, Chinn CH (2009) Update on disparities in oral health and access to dental care for America’s children. Acad Pediatr 9:415–419

    Article  PubMed  Google Scholar 

  • Engel GL (1977) The need for a new medical model: a challenge for biomedicine. Science 196:129–136

    Article  PubMed  CAS  Google Scholar 

  • Graham H, Kelly MP (2004) Health inequalities: concepts, frameworks and policy. Health Development Agency, London

    Google Scholar 

  • Gupta S, Sodhani P, Sharma A et al (2009) Prevalence of high-risk human papillomavirus type 16/18 infection among women with normal cytology: risk factor analysis and implications for screening and prophylaxis. Cytopathology 20:249–255

    Article  PubMed  CAS  Google Scholar 

  • Harper S, King NB, Meersman SC et al (2010) Implicit value judgments in the measurement of health inequalities. Milbank Q 88:4–29

    Article  PubMed  Google Scholar 

  • Jemal A, Ward E, Anderson RN et al (2008) Widening of socioeconomic inequalities in US death rates, 1993–2001. PLoS One 3:e2181

    Article  PubMed  Google Scholar 

  • Kaplan GA (2004) What’s wrong with social epidemiology, and how can we make it better? Epidemiol Rev 26:124–135

    Article  PubMed  Google Scholar 

  • Lemstra M, Neudorf C (2008) Health disparity in Saskatoon: analysis to intervention. Saskatoon Health Region, Saskatoon

    Google Scholar 

  • Link BG, Phelan J (1995) Social conditions as fundamental causes of disease. J Health Soc Behav 35:80–94

    Article  Google Scholar 

  • Lofters AK, Moineddin R, Hwang SW et al (2010) Low rates of cervical cancer screening among urban immigrants: a population-based study in Ontario, Canada. Med Care 48:611–618

    Article  PubMed  Google Scholar 

  • London Health Observatory (2010) Department of Health. Welcome to the health inequalities intervention toolkit. http://www.lho.org.uk/LHO_Topics/Analytic_Tools/HealthInequalitiesInterventionToolkit.aspx. Accessed 31 Jan 2011

  • Lynch JW, Davey Smith G, Kaplan GA et al (2000) Income inequality and mortality: Importance to health of individual income, psychosocial environment, or material conditions. BMJ 320:1200–1204

    Article  PubMed  CAS  Google Scholar 

  • Lynch J, Davey Smith G, Harper S et al (2004a) Is income inequality a determinant of population health? Part 2. US national and regional trends in income inequality and age and cause specific mortality. Milbank Q 82:355–400

    Article  PubMed  Google Scholar 

  • Lynch J, Davey Smith G, Harper S et al (2004b) Is income inequality a determinant of population health? Part 1. A systematic review. Milbank Q 82:5–99

    Article  PubMed  Google Scholar 

  • Lynch J, Davey Smith G, Harper S et al (2006) Explaining the social gradient in coronary heart disease: comparing relative and absolute risk approaches. J Epidemiol Community Health 60:436–441

    Article  PubMed  Google Scholar 

  • Mackenbach JP, Bos V, Andersen O et al (2003) Widening socioeconomic inequalities in mortality in six Western European countries. Int J Epidemiol 32:830–837

    Article  PubMed  Google Scholar 

  • Mansbridge JN, Brown MD (1985) Changes in dental caries prevalence in Edinburgh children over three decades. Community Dent Health 2:3–13

    PubMed  CAS  Google Scholar 

  • Marmot M (2005) Social determinants of health inequalities. Lancet 365:1099–1104

    PubMed  Google Scholar 

  • Marmot M (2010) Fair society, health lives: strategic review of health inequalities in England post-2010. The Marmot review, London. http://www.marmotreview.org/. Accessed 31 Jan 2011

  • Marmot MG, Shipley MJ, Rose G (1984) Inequalities in deatt: specific explanations of a general pattern? Lancet 323:1003–1006

    Article  Google Scholar 

  • Marmot M, Ryff CD, Bumpass LL et al (1997) Social inequalities in health: next questions and converging evidence. Soc Sci Med 44:901–910

    Article  PubMed  CAS  Google Scholar 

  • O’Flaherty M, Bishop J, Redpath A et al (2009) Coronary heart disease mortality among young adults in Scotland in relation to social inequalities: time trend study. BMJ 339:b2613

    Article  PubMed  Google Scholar 

  • Ontario Public Health Association and Association of Public Health Agencies (2010) Activities to address the social determinants of health in Ontario Local Public Health Units. Summary Report. Joint OPHA/alPHa Working Group on Social Determinants of Health, Sudbury

    Google Scholar 

  • Pampalon R, Raymond G (2000) A deprivation index for health and welfare planning in Quebec. Chronic Dis Can 21:104–113

    PubMed  CAS  Google Scholar 

  • Paradis G (2009) Social determinants of health: so what? Can J Public Health 100:164

    PubMed  Google Scholar 

  • Public Health Agency of Canada (2008) Canadian perinatal health report, 2008th edn. Public Health Agency of Canada, Ottawa

    Google Scholar 

  • Public Health Agency of Canada (2010) Creating a healthier Canada: making prevention a priority. Declaration on prevention and promotion from Canada’s ministers of health and health promotion/healthy living. Public Health Agency of Canada, Ottawa

    Google Scholar 

  • Region of Peel Public Health (2008) A picture of health. A comprehensive report on health in Peel, 2008. Region of Peel Public Health, Brampton

    Google Scholar 

  • Rose G (1985) Sick individuals and sick populations. Int J Epidemiol 14:32–38

    Article  PubMed  CAS  Google Scholar 

  • Rose G (1992) The strategy of preventative medicine. Oxford University Press, New York

    Google Scholar 

  • Rosenstock I, Strecher V, Becker M (1988) Social learning theory and the health belief model. Health Educ Q 15:175–183

    Article  PubMed  CAS  Google Scholar 

  • Ross NA, Wolfson MC, Dunn JR et al (2000) Relation between income inequality and mortality in Canada and in the United States: cross sectional assessment using census data and vital statistics. BMJ 320:898–902

    Article  PubMed  CAS  Google Scholar 

  • Ross NA, Tremblay SS, Graham K (2004) Neighbourhood influences on health in Montreal, Canada. Soc Sci Med 59:1485–1494

    Article  PubMed  Google Scholar 

  • Rothman KJ, Adami HO, Trichopoulos D (1998) Should the mission of epidemiology include the eradication of poverty? Lancet 352:810–813

    Article  PubMed  CAS  Google Scholar 

  • Shankardass K, Solar O, Murphy K et al (2010) Health in all policies: a snapshot for Ontario. Results of a realist-informed scoping review of the literature. In: Getting started with health in all policies: a resource pack. Report to the Ministry of Health and Long-Term Care (Ontario). Centre for Research on Inner City Health, St. Michael’s Hospital, Toronto. http://www.stmichaelshospital.com/knowledgeinstitute/search/details.php?id=18218&page=1. Accessed 12 May 2011

  • Statistics Canada (2009) Immigration and citizenship highlight tables, 2006 census. Statistics Canada, Ottawa. http://www12.statcan.gc.ca/census-recensement/2006/dp-pd/hlt/97-557/Index-eng.cfm. Accessed 31 Jan 2011

  • Statistics Canada publication (2006) Health reports, Catalogue 82-003, 17(3):57. http://www.statcan.gc.ca/studies-etudes/82-003/archive/2006/9279-eng.pdf

  • Steele J, Lader D (2004) Children’s dental health in the United Kingdom, 2003. Social factors and oral health in children. Office for National Statistics, London

    Google Scholar 

  • Stellman SD, Resnicow K (1997) Tobacco smoking, cancer and social class. IARC Sci Publ 138:229–250

    PubMed  Google Scholar 

  • Subramanian SV, Kawachi I (2004) Income inequality and health: what have we learned so far? Epidemiol Rev 26:78–91

    Article  PubMed  CAS  Google Scholar 

  • Susser M, Susser E (1996) Choosing a future for epidemiology: II. From black box to Chinese boxes and eco-epidemiology. Am J Public Health 86:674–677

    Article  PubMed  CAS  Google Scholar 

  • Syme SL (1996) Rethinking disease: where do we go from here? Ann Epidemiol 6:463–468

    Article  PubMed  CAS  Google Scholar 

  • Syme SL (2008) Reducing racial and social-class inequalities in health: the need for a new approach. Health Aff (Millwood) 27:456–459

    Article  Google Scholar 

  • Wilkinson RG (1997) Socioeconomic determinants of health: health inequalities: relative or absolute material standards? BMJ 314:591–595

    PubMed  CAS  Google Scholar 

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Correspondence to David Mowat .

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Mowat, D., Chambers, C. (2012). Producing More Relevant Evidence: Applying a Social Epidemiology Research Agenda to Public Health Practice. In: O’Campo, P., Dunn, J. (eds) Rethinking Social Epidemiology. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-2138-8_15

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