Current Debates in Philosophy of Science (PHIL*4140)
Code and section: PHIL*4140*01
Term: Winter 2020
Instructor: Maya Goldenberg
Philosophy of Population Health Science: The New Public Health
Something big has been happening in the world of public health science: an effort to revise, reform, and revolutionize how we think about and practice health promotion for groups of people. Commentators call this shift in public health science “population health science”, “the population health approach”, or “public health 3.0”, while others choose to characterize the shift as what good contemporary public health ought to be (and so no new name is needed). Population health science (or whatever you want to call it) is defined as:
a research program that confronts the structural forces that place individuals
at risk, creates distributions of health and disease unequally across socially
defined groups, and focuses on embedding biological pathways within social
interactions that develop across the life course and across generations (Keyes
and Galea 2016: 634).
The goals of population health science are to reconstruct the theory and practice of how to promote the health of populations, in reaction to the lessons learned from 20th century public health and health care. The insights and interventions into health promotion eschew the individualistic and reductive tendencies of 20th century biomedicine. Population health science also embraces an expansive view of the social determinants of health (i.e. access to healthy food, safe housing, effective gun policy, freedom from stigma) that has previously unnerved public health scholars because of concerns about medical hegemony (where all social ills are medicalized). Lastly, population health science rejects the common view that science and activism must be kept apart. Public Health Science’s comparative approach to population health, where scholars seek to determine “why are some people healthy and others not?” (Evans et al. 2014), invites activism directed at promoting health equity and justice.
The development of this new theoretical and practical field of population health promotion over the past few decades has taken place in various public health and related disciplinary journals and books, with little attention from philosophy. The main text for this course, Philosophy of Population Health Science (2018), now offers a first philosophical analysis of population health science and the associated population health approach. The text draws from philosophy of medicine, philosophy of biology, and public health ethics to analyze and synthesize what is philosophically novel or notable about the shift, to show how population health science’s fragmentary theoretical and methodological pieces do indeed fit together, and to consider how population health science addresses some philosophical problems that have challenged public health science and the study of social determinants of health. For example, how do we define health? How do we conceptualize the causes of health and illness? How do health equity values fit into the science and practice of population health promotion?
These questions will be addressed in this class.
Evans, R. G., Barer, M. L. and Marmor, T. R. 1994. Why Are Some People Healthy and Others Not? The Determinants of Health of Populations. New York: Aldine De Gruyter.
Keyes, K. M. and Galea, S. 2016. Setting the agenda for a new discipline: Population health science. American Journal of Public Health 106, 633–634.
Valles, S. A. 2018. Philosophy of Population Health: Philosophy for a New Public Health Era. New York: Routledge.