Using a Health Equity Framework in Research to Address Unmet Social Needs

Dear Colleagues,

As many of you are aware, first introduced in the 1940s, social ecology is a seminal theoretical model in public health research. The idea that an individual’s health and well-being are influenced by factors at multiple “levels” countered the tendency to approach health narrowly in terms of seemingly autonomous and self-contained individuals. However, although the model encompasses the idea of a broader health “ecology” or “environment,” it still generally lacks theoretical complexity about mechanisms and pathways of influence or their intersections.

However, as socio-ecological innovations in public health research gained momentum, the emphasis evolved. Previously underappreciated domains of an individual’s life outside the realm of healthcare were increasingly acknowledged as factors significantly influencing health outcomes. With growing recognition of the extent to which social and structural factors outside of the control of individuals are key drivers of health outcomes—often more so than the healthcare system itself—the concept of social determinants of health (SDoH) emerged as a more holistic and integrated way to think about individuals as located within an even more complex context—an environment more broadly defined. As a result, the concept of SDoH has drawn attention to disparate health outcomes and the social and structural dynamics that produce them. This “health disparities” lens is important for revealing unjust and inequitable geographies of health risk, disease, suffering, and death. Furthermore, in parallel with these paradigm changes, there is growing recognition that community engagement and stakeholder involvement are essential to improving health outcomes.

SDoH thinking has produced valuable innovations in healthcare, health research, and funding. These innovations are reflected in the now large body of SDoH literature. There is an increased emphasis on identifying and addressing social needs, and on “upstream strategies” such as multisectoral collaboration, “collective impact,” and policy change. Community engagement has been further prioritized with ongoing refinement of strategies for enabling equitable participation of diverse stakeholders. However, as the SDoH paradigm has become embedded in healthcare and public health circles, too often understanding of SDoH still remains tied to a static, one-dimensional conceptualization of context using a narrow socio-ecological emphasis on “barriers” and “promotors.” As my colleagues and I previously argued, acknowledging that individuals exist within a context of social determinants does not necessarily lead to the investigation of how those social determinants operate. As such, theoretical frameworks such as structural violence, intersectionality, and syndemics, and the incorporation of life-course approaches in research, provide opportunities to illuminate the structures, mechanisms, and pathways that operate through complex, intersecting webs of influence to become the SDoH that shape health and social landscapes in both negative and positive ways.

Similarly, the health disparities focus that importantly drew our attention to inequitable health outcomes has been embraced by researchers, providers, and funders, transforming, to some extent, the way that resources are allocated, the goal of research studies, and the content of public health literature. However, disparity framing has also been critiqued as failing to disrupt deficit narratives and thinking that can operate to reproduce oppression and inequality. Health disparities and social inequality do not merely exist as a reflection of some assumed “natural” state of affairs, they are constantly produced and reproduced through quotidian dynamics of everyday life.

It has become increasingly clear that we need critical dialogues about positionality, privilege, and power to produce a more complete and integrated understanding of the way that health and wellbeing are socially constructed with attention to the racial, ethnic, social, and economic power structures undergirding these processes. Research frameworks that emphasize health equity and align with participatory, community-engaged practices are providing new powerful tools in this regard. This Special Edition is seeking submissions from scholars working in this domain in order to contribute to the knowledge base of equity as a guiding principle in research to address social needs.

Call for Submissions

The International Journal of Environmental Research and Public Health (IJERPH) is accepting submissions for a Special Issue on “Using an Equity Framework in Research to Address Unmet Social Needs.” The “environmental” focus of this call is broadly defined to refer to social, structural, and physical domains, including but not limited to economics, social relationships, education, politics, health systems, religious institutions, culture, the food environment/system, policy, racism, structural racism, and hierarchies of race, class, gender, and ethnicity. Submissions that use social determinants of health, structural violence, intersectionality, syndemic, and life-course approaches that investigate social dynamics and mechanisms, and problematize complexity are encouraged. Authors should identify the equity framework that was used and include discussion of any relevant racial, ethnic, social, and economic power dynamics and structures.

New research papers, reviews, case reports and papers describing important lessons learned are welcome to this issue. Other manuscript types accepted include methodological papers, process papers, position papers, brief reports, and commentaries. We will accept manuscripts from diverse disciplines including social sciences (e.g., anthropology, sociology, psychology, political science), health sciences, health systems research, epidemiology, and population health/public health.

Dr. Janet Page-Reeves
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

• health equity
• social needs
• social determinants of health (SDoH)
• structural violence
• intersectionality
• syndemics
• life-course