Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Int J Soc Determinants Health Health Serv. 2024 Oct;54(4):331-342. doi: 10.1177/27551938241269188. Epub 2024 Aug 16.
This critical review considers the status of 21st-century epidemiological theories of disease distribution, updating to 2024 prior analyses published up through 2014, and discusses the implications of these theories for research, practice, and pedagogy. Three key trends stand out: () the continued dominance of individualistic biomedical and lifestyle theories; () growth and elaboration of social epidemiological alternatives; and () the ongoing inattention to epidemiologic theories of disease distribution in the training of epidemiologists and public health professionals and in current efforts to improve the rigor of epidemiological research and causal inference. In a context of growing global political polarization, climate crisis, broader environmental and ecological crises, and stubbornly persistent health inequities within and between nations, producing actionable knowledge relevant to improving the people's health and advancing health justice will require much greater engagement with social epidemiologic theories of disease distribution in research, pedagogy, and practice. At issue is critically engaging with the embodied truths manifested in the stories bodies tell in population patterns of health, disease, and well-being.
这篇评论性文章回顾了 21 世纪疾病分布的流行病学理论现状，更新至 2024 年，对截至 2014 年发表的先前分析进行了更新，并讨论了这些理论对研究、实践和教学的意义。有三个关键趋势值得关注：（1）个体主义的生物医学和生活方式理论继续占主导地位；（2）社会流行病学替代理论的发展和完善；（3）在流行病学家和公共卫生专业人员的培训中以及在当前提高流行病学研究和因果推断严谨性的努力中，对疾病分布的流行病学理论仍然关注不够。在全球政治两极分化加剧、气候危机、更广泛的环境和生态危机以及国家内部和国家之间顽固存在的健康不平等的背景下，要想产生与改善民众健康和推进健康正义相关的可行知识，就需要在研究、教学和实践中更深入地参与到疾病分布的社会流行病学理论中。关键在于认真对待体现在人群健康、疾病和福祉模式中的身体所讲述的故事中的具体事实。
