Social justice and equality – in search of John Cassel’s epidemiology

EPID799C sec02, Spring 2014

Instructors: Bill Jenkins, Vic Schoenbach

“Epidemiology is fundamentally engaged in the broader quest for social justice and equality.”  John Cassel used these words to characterize epidemiology to Sherman James who, fresh from a psychology doctoral program, would soon join the UNC Epidemiology faculty.  During the ensuing 40 years epidemiology has flourished, but does Cassel’s characterization still apply? 

What would Cassel say about epidemiology’s efforts to eliminate health disparities, a cross-cutting goal of official health policy?  Are epidemiologists looking at real causes of health disparities?  Or are they looking at the causes that are easier to study?  Does community participatory research mean that epidemiologists follow the community’s guidance – or go into the community with a pre-defined agenda?  Under present guidelines, would the Tuskegee study be an exemplary example of community participatory research?  Dr. M.L. King Jr. said that the way we seek social justice is as important as achieving social justice.  Is epidemiology a tool to question the efficacy and ethics of current efforts?  Or does epidemiology mainly justify current efforts? 

This seminar considers the reasons for the persistence of gross disparities by reviewing the movement for health equity in the U.S., beginning with W.E.B. Dubois’ analysis of health in The Philadelphia Negro and the community health center movement inspired by the Karks’ work in Pholela, South Africa. These efforts transformed epidemiology into a fundamental force for pursuing social justice. As such, epidemiology has identified the fundamental role of contextual and structural factors in fostering health inequities. But to address these epidemiologists need to understand their underlying determinants, including human cognitive, behavioral, and biological tendencies, and how these may be influenced by modifiable aspects of the social and physical environment.  By helping to develop a deeper understanding of human social behavior – perhaps the most important modifiable risk factor for health inequity – epidemiology can expand its contributions to the quest for social justice and equality.

This course is less about getting the right answers – and more about asking the right questions. 

For more information, visit https://sakai.unc.edu/x/hXf8rM and come to the first class on Thursday, 1/9, 11:00-12:15, in room 1303 McG.