Receding horizons of health: Biocultural approaches to public health paradoxes

Document Type

Journal Article

Publication Date

1-1-2005

Journal

Social Science and Medicine

Volume

61

Issue

4 SPEC. ISS.

DOI

10.1016/j.socscimed.2004.08.052

Keywords

Epidemiologic transition; Health policy; Mental health; Population health; Social epidemiology

Abstract

Worldwide challenges to health reflect a "paradox of success," whereby both the strengths and the weaknesses of current approaches in public health, epidemiology, and biomedicine have determined the nature of the health problems we now face. In detail, we analyze and illustrate five constituent paradoxes that fuel continued health risk even in the face of success, including: (1) unmasking, (2) local biology, (3) socialization, (4) emerging and reemerging disease, and (5) savage inequity. We trace the pathways behind the paradoxes and their effects on health, and demonstrate that biocultural dynamics are involved in each. Furthermore, we track the roots of health paradox to changes that divert or disrupt pathways for production of health. These analyses contribute to an emerging literature of research and praxis on integrative biocultural models of health. © 2004 Elsevier Ltd. All rights reserved.

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