Public Health's Next Step in Advancing Equity: Re-evaluating Epistemological Assumptions to Move Social Determinants...

Area of Science:

• Public Health
• Health Equity
• Social Epidemiology

Background:

• Public health increasingly adopts a social ecological approach, recognizing social and structural determinants of health.
• However, research and practice often remain rooted in an individualistic, biomedical paradigm.
• This disconnect hinders progress in health equity and systems-level change.

Purpose of the Study:

• To critically examine the limitations of the biomedical paradigm in public health.
• To highlight the challenges in achieving health equity due to persistent biomedical practices.
• To provide theoretical and epistemological guidance for a paradigm shift towards social ecological approaches.

Main Methods:

• Analysis of the foundations and limitations of the biomedical paradigm in public health.
• Review of existing critiques of biomedical approaches in the context of social determinants.
• Examination of health equity challenges arising from conventional public health practices.

Main Results:

• The biomedical paradigm, despite acknowledging social determinants, limits the ability to broaden well-being concepts and advance systems-level change.
• Over-reliance on biomedical practices impedes efforts to address root causes of health inequities.
• A significant gap exists between social ecological theory and current public health practice.

Conclusions:

• Public health must fully transition from a biomedical to a social ecological paradigm to effectively address health equity.
• Integrating social ecological theory into practice is crucial for advancing health equity.
• Innovative strategies are needed to bridge the gap between theory and practice for systems-level health improvement.