Primary Submission Category: Health equity
Finding the ethical commitments required by population health science’s theoretical commitments
Authors: Sean Valles
Presenting Author: Sean Valles*
Previous scholarship has worked to synthesize the core theoretical commitments that make population health science a unique scientific framework. Keyes and Galea (2016) propose six Foundational Principles of Population Health Science, and Valles (2018) proposes that humility (about health knowledge and expertise) plays a special role in the field. This presentation expands on previous work by showing how the core theoretical elements of population health science also push the field toward accepting certain ethical commitments as guiding norms.
Population health science historically grew out of a 1993 edited book asking “why are some people [in the sense of population] sick and others not?” That focus on disparities meshes with Rose’s foundational 1992 book, The Strategy of Preventive Medicine, which begins by declaring, “There is no known biological reason why every population should not be as healthy as the best.” The group Public Health Liberation later described this type of statement as a rejection of the “fallacy of the health inequity fatalism”—an important step towards liberatory social reforms. The combined focus on between-population disparities, and the rejection of poor population health as inevitable, leads population health science to an inherent ethical commitment to seeking to ameliorate disparities.
Other theoretical developments point the field toward additional specific ethical commitments, including : 1) life course theory’s centrality leads to an ethical obligation to intervene across stages of human development and also intergenerational traumas (e.g. reparations for plantation slavery and genocide against indigenous peoples); 2) the field’s focus on upstream prevention of health ills via reforming social conditions requires opposing political and ethical critiques that say population/public health must ‘stay in its lane’ by keeping such considerations out of most social policymaking (gun regulation, housing reform, urban design, etc.).