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Epidemiology and the Macrosocial Determinants of Health

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Abstract

In the past two decades, public health researchers have taken renewed interest in investigating the role of social factors in health. This holds substantial promise in terms of identifying manipulable social factors that are amenable to policy intervention. Most existing empirical and conceptual epidemiologic work, however, has focused on the more proximal social determinants, such as interpersonal relations. These factors, although perhaps easier to study epidemiologically, are much less relevant to policy makers than more “macrosocial” factors such as taxation policies. Limited epidemiologic attention to macrosocial determinants of health is ironic given that macrosocial factors such as the rapid industrialization and urbanization in the 19th century contributed to the organization of public health practice and, tangentially, to academic public health research. We suggest here that greater investment in the study of macrosocial determinants has the potential to make a significant and unique contribution to the greater public health agenda and should be a prominent aspect of social epidemiologic inquiry in the coming decades.

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Authors and Affiliations

  1. Center for Urban Epidemiologic Studies, New York Academy of Medicine, New York, NY, USA

    Sara Putnam & Sandro Galea

  2. Department of Epidemiology, Center for Social Epidemiology and Population Health, University of Michigan School of Public Health, Ann Arbor, MI, USA

    Sandro Galea

  3. Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA

    Sandro Galea

Authors
  1. Sara Putnam
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  2. Sandro Galea
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Correspondence to Sandro Galea.

Additional information

To understand the effects of macrosocial determinants on health, the authors challenge epidemiologists to study elements of social policy, such as taxation. Such studies will make an increasingly important contribution to public health.

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Putnam, S., Galea, S. Epidemiology and the Macrosocial Determinants of Health. J Public Health Pol 29, 275–289 (2008). https://doi.org/10.1057/jphp.2008.15

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