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1、©InternationalEpidemiologicalAssociation2001PrintedinGreatBritainInternationalJournalofEpidemiology2001;30:668–677Theoriesforsocialepidemiologyinthe21stcentury:anecosocialperspectiveNancyKriegerKeywordsEcology,epidemiology,gender,inequality,politicalscienc
2、e,psychosocial,race/ethnicity,racism,socialclass,socialdeterminantsofhealth,socialscience,socio-economic,theory‘Boththinkingandfactsarechangeable,ifonlybecausechangesofdeprivationandprivilege.Commentstothiseffectcanbeinthinkingmanifestthemselvesinchangedfa
3、cts.Conversely,foundintheHippocraticcorpus4andinearlytextsofancientfundamentallynewfactscanbediscoveredonlythroughnewChinesemedicine.5Sharedobservationsofdisparitiesinhealth,thinking.’LudwickFleck(1935)GenesisandDevelopmentofahowever,donotnecessarilytransl
4、atetocommonunderstand-ScientificFact.1,pp.50–51ingsofcause;itisforthisreasontheoryiskey.ConsideronlycenturiesofdebateintheUSoverthepoorhealthofblack‘Oncewerecognizethestateoftheartisasocialproduct,Americans.Inthe1830sand1840s,contraryschoolsofthoughtwearef
5、reertolookcriticallyattheagendaofourscience,itsask:isitbecauseblacksareintrinsicallyinferiortowhites?—conceptualframework,andacceptedmethodologies,andtothemajorityview,orbecausetheyareenslaved?—asarguedbymakeconsciousresearchchoices.’RichardLevinsandRichar
6、dDrJamesMcCuneSmith(1811–1865)andDrJamesSRockLewontin(1987)TheDialecticalBiologist.2,p.286(1825–1866),twoofthecountry’sfirstcredentialledAfricanAmericanphysicians.6Incontemporaryparlance,thequestionsbecome:dothecauseslieinbadgenes?,badbehaviours?,orTheorya
7、ccumulationsofbadlivingandworkingconditionsbornofInsocialepidemiology,tospeakoftheoryissimultaneouslytoegregioussocialpolicies,pastandpresent?7,8Thefundamentalspeakofsocietyandbiology.Itis,Iwillargue,tospeakofem-tension,thenandnow,isbetweentheoriesthatseek
8、causesofbodiment.Atissueishowweliterallyincorporate,biologically,socialinequalitiesinhealthininnateversusimposed,orindi-theworldaroundus,aworldinwhichwesimultaneouslyarevidualversussocietal,characteristics.bu