Social Inequality in Population Developmental Health: An Equity and Justice Issue

The conceptual framework for this chapter focuses on outcomes in developmental health as a key indicator of equity. Not all disparities in developmental health are indicators of a failure of equity and justice, but those that are clearly linked to social patterns in theoretically coherent and empirically substantial ways serve as a powerful diagnostic tool. They are especially diagnostic when they point to social factors that are remediable, especially in comparison to societies in which such social disparities are sharply lower (Keating, Siddiqi, & Nguyen, 2013). In this chapter, I review the theoretical links and empirical evidence supporting this central claim and propose that there is strong evidence for the following critical links: (a) there is a compelling empirical connection between disparities in social circumstances and disparities in developmental health outcomes, characterized as a social gradient effect; (b) "drilling down" reveals the core biodevelopmental mechanisms that yield the social disparities that emerge across the life course; (c) in turn, life course effects on developmental health have an impact on societies and populations that are revealed by "ramping up" the research to consider international comparisons of population developmental health; and (d) viewing this integrated evidence through the lens of equity and justice helps to break the vicious cycle that reproduces social inequality in a distressingly recurring fashion.