This research cluster deconstructs deterministic discourses of health outcomes that are often enacted in current health literature. Specifically, we analyze how existing scholarly works use the conceptual framework of “social determinants of health” (SDoH) to disrupt its present limitations. In many ways, the growing tendency to define certain factors caused by structural inequalities as a SDoH has obscured personal agency while reinforcing essentialist assumptions of “social” factors such as race and gender (Roberts and Rollins 2020; Annandale and Hammarström 2011). The appeal of resorting to SDoH discourses has also failed to demand accountability among key actors and institutions and actively address the systemic consequences of structural inequalities (Graham 2004).
Through conducting a close literature review, we begin breaking down the major concepts of SDoH including policy, gender, infrastructure, race, among other identifying keywords. Within each essay below, we critique the deterministic assumptions that undergird our selected keywords and speculate on ways to complicate, deepen, or expand on them.
Each essay takes into account the long history of SDoH in global health initiatives. “Policy” by Sally Yan examines how discourses of SDoH have been deployed and legitimized in legal and political regimes. “Gender” by Jason Lee examines how Euro-American binary conceptualizations of sex and orientation have become the dominant framework of understanding gender as an SDoH. “Infrastructure” by Aruni Areti highlights how the engineering metaphors of infrastructure obscure the connections between situated experiences and environmental context. “Race” by Taylor Phillips problematizes the biologically deterministic discourses that underlie the categorization of race and ethnicity as a metric of public health outcomes. In turn, the essay elucidates how such a metric has contributed to the othering of certain populations from the idealized, exclusionary, and homogenous “public” (Warner 2005).
The Keyword Search unravels the modern conceptions of public health and raises questions such as who is a part of the “public,” how is membership determined within the public, who is responsible for the public, and ultimately, what happens to those excluded from the public (Warner 2005).
Annandale, Ellen, and Anne Hammarström. 2011. “Constructing the ‘Gender-Specific Body’: A
Critical Discourse Analysis of Publications in the Field of Gender-Specific Medicine.” Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine 15 (6): 571–87.
Graham, Hilary. 2004. “Social Determinants and Their Unequal Distribution: Clarifying Policy
Understandings.” The Milbank Quarterly 82 (1): 101–24.
Roberts, Dorothy E., and Oliver Rollins. 2020. “Why Sociology Matters to Race and Biosocial
Science.” Annual Review of Sociology 46 (1): 195–214.
Warner, Michael. 2005. Publics and Counterpublics. New York: Zone Books.