Section outline

  • Lecture:  Classic conceptual papers

    Seminal theories and frameworks that have shaped discourse about the nature and etiology of health disparities and the role of social determinants of health.

    Faculty:  Christine Dehlendorf

    Location:       Mission Hall 1406

    • Session Slides:

    • Session Audio/Video Recording (Access restricted to registered students):

    • Watch URL
      Not available unless: You belong to a group in Registered Students Only

    • Required Reading:

    • Link and Phelan, Social conditions as fundamental causes of disease File
      Not available unless: Your ID number contains 02
    • Phelan JC, Link BG. Is racism a fundamental cause of inequalities in health. Annual Review of Sociology. 2015 Aug 14;41311-30 File
      Not available unless: Your ID number contains 02
    • Krieger N. Theories for social epidemiology in the 21st century an ecosocial perspective. International journal of epidemiology. 2001 Aug 1;30(4)668-77. File
      Not available unless: Your ID number contains 02
    • Krieger N. Epidemiology and the web of causation has anyone seen the spider. Social science medicine. 1994 Oct 1;39(7)887-903. Required reading starting on page 896 until the end. The rest of the article is optional. File
      Not available unless: Your ID number contains 02

    • Optional Reading:

    • The Krieger article, as above

    • Lynch J and Kaplan G. Chapter 2, Socioeconomic Position. In: Berkman LF and Kawachi I (eds). Social Epidemiology. New York: Oxford University Press (2000), pp. 13-35 URL
      Not available unless: Your ID number contains 02
    • Susser M, Susser E. Choosing a future for epidemiology I. Eras and paradigms. American Journal of Public Health. 1996 May;86(5)668-73. File
      Not available unless: Your ID number contains 02
    • McMichael M. Prisoners of the Proximate Loosening the Constraints on Epidemiology in an Age of Change. Am J Epidemiology 1999 149;10887-97. File
      Not available unless: Your ID number contains 02

    • Resources:


    • Assignment:

      Below are discussion questions we will consider in class for each reading. Please think about these as you do the readings and be prepared to discuss them. If you will not attend class, please submit written responses to each question of approximately one half to one page per question (email to christine.dehlendorf@ucsf.edu).

      Link and Phelan:
      1. How would you describe the essential shift in thinking within epidemiology that the authors of this paper urge?
      2. What are the key insights of fundamental cause theory about the role of social conditions on health?
      3. What are the implications of the fundamental cause theory for research on health disparities?
      Phelan and Link:
      1. What is the shift in thinking about the role of race in health that is evidenced between this paper and the original fundamental cause paper published in 1995 (the first reading)?
      2. Do you agree that “a large proportion of the racial differences in health outcomes are attributable to racial differences in SES”? Why or why not?
      3. What implication does considering racism as a fundamental cause have for research on health disparities?
      Krieger papers:
      1. What is meant by the “spiderless web”?
      2. What are the strengths and limitations of psychosocial theory? Of social production of disease?
      3. How does ecosocial theory relate to fundamental cause theory?
      4. Is theory necessary to advance health equity? Why or why not?
      5. Describe the central concept of embodiment.