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Public Health Ethics Advance Access originally published online on December 5, 2008
Public Health Ethics 2009 2(1):70-83; doi:10.1093/phe/phn035
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© The Author 2008. Published by Oxford University Press. Available online at www.phe.oxfordjournals.org

In Support of a Broad Model of Public Health: Disparities, Social Epidemiology and Public Health Causation

Daniel S. Goldberg*

Baylor College of Medicine

* Corresponding Author, Health Policy & Ethics Fellow, Chronic Disease Prevention & Control Research Center, Department of Medicine, Baylor College of Medicine, 1709 Dryden, Suite 1025, Houston, TX 77030, USA. Tel.: 713.798.5482; Fax: 713 798 3990; Email: danielg{at}bcm.edu.


  Abstract

This article defends a broad model of public health, one that specifically addresses the social epidemiologic research suggesting that social conditions are primary determinants of health. The article proceeds by critiquing one of the strongest arguments in favor of a narrow model, advanced by Mark Rothstein. The critique sets up the argument that a model of public health that does not address what actually causes health and disease is unlikely to improve public health. Assessing the substantial evidence regarding the social determinants of health, the article engages the policy paradox that precludes utopian prescriptions but demands more than mere expedience.


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