Social Epidemiology and Health

Social Epidemiology and Health

Social epidemiology studies the social distribution and social determinants of health.

Learning Objectives

Discuss epidemiolgy and its impact on American health care, as well as its beginnings based on Durkheim’s work on suicide

Key Takeaways

Key Points

  • Epidemiology is the study (or the science of the study) of the patterns, causes, and effects of health and disease conditions in defined populations.
  • Social epidemiology is defined as “the branch of epidemiology that studies the social distribution and social determinants of health”; or in other words, “both specific features of, and pathways by which, societal conditions affect health”.
  • Social epidemiologists generally use social concepts in order to explain patterns of health in the population.
  • The roots of social epidemiology go back to the work of Emile Durkheim on suicide, where he explored the differing suicide rates between Protestants and Catholics.
  • Use of multilevel models (also known as hierarchical and mixed effects models) involves focusing on both individual-level measures and emergent social properties that have no correlation at the individual level.

Key Terms

  • Emile Durkheim: David Émile Durkheim (April 15, 1858 – November 15, 1917) was a French sociologist. He formally established the academic discipline and, with Karl Marx and Max Weber, is commonly cited as the principal architect of modern social science and father of sociology.
  • Social epidemiology: Social epidemiology is defined as “the branch of epidemiology that studies the social distribution and social determinants of health,” that is, “both specific features of, and pathways by which, societal conditions affect health. “
  • Multilevel Models: Multilevel models are statistical models of parameters that vary at more than one level. These models can be seen as generalizations of linear models (in particular, linear regression), although they can also extend to non-linear models.

Epidemiology

Epidemiology is the study (or the science of the study) of the patterns, causes, and effects of health and disease conditions in defined populations. It is the cornerstone of public health, and informs policy decisions and evidence-based medicine by identifying risk factors for disease and targets for preventive medicine. Epidemiologists help with study design, collection and statistical analysis of data, and interpretation and dissemination of results (including peer review and occasional systematic review). Epidemiology has helped develop methodology used in clinical research, public health studies and, to a lesser extent, basic research in the biological sciences.

Major areas of epidemiological study include disease etiology, outbreak investigation, disease surveillance and screening, biomonitoring, and comparisons of treatment effects such as in clinical trials. Epidemiologists rely on other scientific disciplines like biology to better understand disease processes, statistics to make efficient use of the data and draw appropriate conclusions, social sciences to better understand proximate and distal causes, and engineering for exposure assessment.

Social Epidemiology

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Émile Durkheim: Durkheim formally established the academic discipline and, with Karl Marx and Max Weber, is commonly cited as the principal architect of modern social science and father of sociology.

Social epidemiology is defined as “the branch of epidemiology that studies the social distribution and social determinants of health”; or in other words, “both specific features of, and pathways by which, societal conditions affect health” (Krieger, 2001). The roots of social epidemiology go back Emile Durkheim’s work on suicide.

In Suicide (1897), Durkheim explores the differing suicide rates between Protestants and Catholics, arguing that stronger social control among Catholics results in lower suicide rates. According to Durkheim, Catholic society has normal levels of integration while Protestant society has low levels. Overall, Durkheim treated suicide as a social fact, explaining variations in its rate on a macro level, considering society-scale phenomena such as a lack of connections between people (group attachment) and a lack of regulations of behavior, rather than the feelings and motivations of individuals. Despite its limitations, Durkheim’s work on suicide has influenced proponents of control theory, and is often mentioned as a classic sociological study. The book pioneered modern social research and served to distinguish social science from psychology and political philosophy.

Social epidemiology may focus on individual-level measures, or on emergent social properties that have no correlation at the individual level. Simultaneous analysis at both levels may even be warranted. Use of such multilevel models is also known as hierarchical and mixed effects models. Social epidemiology overlaps with fields in the social sciences, such as medical anthropology, medical sociology, and medical geography. However, these fields often use health and disease in order to explain specifically social phenomenon (such as the growth of lay health advocacy movements), while social epidemiologists generally use social concepts in order to explain patterns of health in the population.