Abstract:
Rigorous scientific research on understanding and reducing health disparities is
essential, as is federal support for this work. The problems of unjust suffering
that we confront are huge, both within the United States and globally. To rectify
these wrongs, we need a clear understanding of their causes. The research we
need to do necessarily draws on insights from many disciplines and must be
concerned with multiple levels of determinants and outcomes and their embodiment
across the lifecourse, in different historical generations and different geographic
locales.
While the specifics of how we approach these issues may vary
by research topic, we nevertheless all confront the same three fundamental questions.These are:
- what are health disparities?
- what are their causes?
- who is responsible for health inequities?
In my presentation, I will contend that
while there may be many partial correct answers to these questions, not all
answers are equal and some are out right wrong. To make this case, I will first
offer a brief historical reminder that we are not the first to debate these issues.
Second, I will argue for why we need an analytic, rather than descriptive, definition
of health disparities. Third, I will present several case examples, including
some of our new work on current and changing inequities in US premature mortality,
to clarify why the science of health disparities is about correct science,
not “politically correct” science. And throughout, I will draw attention to some
salient elephants, including several in the room whom we need to name if our
work is to make a dent in eliminating health inequities.
Bio for Nancy Krieger, PhD
Professor of
Society, Human Development,
and Health at the Harvard School
of Public Health, Associate
Director of the Harvard Center for
Society and Health, and Co-Director of the HSPH
Interdisciplinary Concentration on
Women, Gender, and Health. She
received her PhD in Epidemiology
from the University of California
at Berkeley in 1989. Dr. Krieger
is a social epidemiologist, with a
background in biochemistry, philosophy
of science, and the history
of public health, combined
with 25 years of experience as an
activist in issues involving social
justice, science, and health. |