Measuring Equity and Mutuality: Reflections on the Epidemiology of Social Justice

INTRODUCTION:  Epidemiology has provided a fruitful mechanism for exploring inequalities in health and their origins in forms of social injustice. However, how valid this approach remains is open to discussion. The evidence underpinning this debate and possible ways forward are explored in this presentation.  

METHODS:  Literature review and synthesis.      

RESULTS:  Recent public health analyses have begun to highlight the limitations of the epidemiological approach  in relation to existing and emerging public health challenges. Work on the "Glasgow Effect" (Walsh et. al. 2010) has questioned the degree to which health inequalities may be attributed to economic inequality and the growth of an ecological discourse in explaning possible future health experiences highlight these limitations (Lang & Rayner 2012a & 2012b) . There is also a concern that the focus on equity has resulted in a marginalisation of mutuality as an underlying requirement for socially just outcomes in population health (Mackie P 2010).

CONCLUSIONS:  The evidence suggests that current epidemiological approaches may not be sufficient to capturing the nuances of socially just, population health in the 21st century. What factors are required to be part of necessary developments of epidemiological methods and analysis must be debated as a matter or urgency.