Philosophy of Population Health

Population health has recently grown from a series of loosely connected critiques of twentieth-century public health and medicine into a theoretical framework with a corresponding -eld of research-population health science. Its approach is to promote the public's health through improving everyday human life: afford-able nutritious food, clean air, safe places where children can play, living wages, etc. It recognizes that addressing contemporary health challenges such as the prevalence of type 2 diabetes will take much more than good hospitals and public health departments. Blending philosophy of science/medicine, public health ethics and history, this book offers a framework that explains, analyses and largely endorses the features that de-ne this relatively new -eld. Presenting a philosophical perspective, Valles helps to clarify what these features are and why they matter, including: searching for health's "upstream" causes in social life, embracing a professional commitment to studying and ameliorating the staggering health inequities in and between populations; and reforming scienti-c practices to foster humility and respect among the many scientists and non- scientists who must work collaboratively to promote health. Featuring illustrative case studies from around the globe at the end of all main chapters, this radical monograph is written to be accessible to all scholars and advanced students who have an interest in health-from public health students to professional philosophers.

Sean A. Valles is Associate Professor, jointly appointed to Michigan State University's Lyman Briggs College and Department of Philosophy, USA.

Acknowledgements Chapter 1: Blueprint of a philosophy of-and for-population health science A brief overview Introduction What is population health science? Why write a book on philosophy of population health science? What will this book accomplish? What are the book's philosophical methods and commitments? What this book is not, and what it will not do Onward Section 1 What should health mean in population health science? Chapter 2 A brief history of the social concept of health and its role in population health science Introduction The biomedical model and the Biostatistical Theory of health Population health as (metaphysically) social health Health is (empirically) social Conclusion: Moving toward a thoroughly social health concept of health Case study: The Standing Rock Sioux Water Protectors Chapter 3 Health as a life course trajectory of complete well-being in social context Introduction: The many debates over health's meaning Life Course Theory Life course lesson 1: Health is best understood as a lifelong phenomenon, not in time slices Life course lesson 2: Population health and individual health are best understood as co-developing dynamically The World Health Organization's definition of health, not what it seems The WHO definition of health is not an operationalized tool for health assessment; it is a toolbox that guides the gathering of tools Making room for health pluralisms: metaphysical, empirical, ethical and methodological Conclusion: An updated health concept for an expansive population health mission Case Study: Addressing health disparities between Aboriginal Australians and settler Australians Section 2 Which causes and effects matter most in population health? Chapter 4 Expanding the boundaries of population health Introduction: health as life course of complete well-being in social context calls for a broad health promotion mandate Continuing from Chapter 3: 'Health issues' - 'healthcare issues' "Boundary problem" problems Political theory and population health An unnecessary philosophical assumption: If X becomes a public health problem then it must be primarily or exclusively a public health problem An incorrect empirical prediction: Broad conceptions of public health predictably lead to harms to the public health professions or to the populations they serve The epistemic risks of erring on the side of wide vs. narrow boundaries for public health Conclusion: Expanding philosophy of population health to catch up with the science and practice Case Study: Global climate change Chapter 5 Prioritizing the right population health causes and effects Introduction: Addressing population health problems at the roots "Fundamental-cause theory": the wrong name for the right approach "Fundamental causes": Paramount importance because of a unique type of stability What is and isn't wrong with risk factors Turning attention from "causes of cases" to "causes of incidence" Philosophy of salutogenesis vs. philosophy of pathogenesis Conclusion Case study: Brazil's AIDS response Section 3 How can population health science better promote health equity? Chapter 6 Managing the inevitable trade-offs in population health science practice Introduction The problem of heterogeneity: Lumping vs. splitting in population health The high risk approach vs. the population approach Decentering the healthcare system to promote population health vs. expanding outward from the healthcare system Evidence-based medicine vs. public health pragmatism Conclusion Case study: the heterogeneous health of migrants Chapter 7 Ethics and Evidence in the Population Health Equity Debates Introduction: Population health science and health equity Health equity is built into population health science The (real and imagined) consequences of an ambiguous understanding of "health equity" Equitable health promotion and health governance Hypothetical problems' outsized influence in population health equity deliberations Conclusion Case study: Investigating racism and racial health disparities Conclusion Chapter 8 Humility as the way forward for population health science, and philosophy thereof Introduction: A spirit of humility and collaboration Embracing epistemic humility Sectoral humility: Non-hierarchical intersectorality Disciplinary Humility: Non-hierarchical interdisciplinarity Population health science education for health professionals Population health science education for all Philosophy of population health science, from a position of service

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