Viewpoints |
European Journal of Public Health—Comments on Ken Judge's article
Vincent Navarro1,21Pompeu Fabra University and 2The Johns Hopkins University
Correspondence: e-mail: vnavarro{at}jhsph.edu
Professor Ken Judge underlines the importance of undertaking research on the politics of health policy. We agree on that. But I do not share his skepticism about the possibility of studying ‘values’ (I assume that he means political values). Political Sciences study not only values but, most importantly, power (class, gender, race, national and other types of power relations) and its expression through political representative institutions. The analysis of how power is distributed in a society, how power is expressed, and how power shapes the nature and quality of a society, including its health outcomes, is of paramount interest. This should be the subject of scholarly work using rigorous methods that add credibility to its intellectual production. It is precisely because the subject of analysis is power and its expression through public policies that researchers are reluctant to study it. Their tenure often depends on powerful institutions not likely to welcome these types of studies.
We can see, for example, that most of the emphasis by social epidemiologists in the growing field of social determinants of health is on the psychosocial and cultural determinants—rarely on the political determinants. This selective focus is not the result of the difficulty of studying the subject, but rather is due to its political sensitivity. The psychosocial and cultural have an individual focus, while political factors require an analysis of collective power relations that can produce some headaches for those who dare to conduct such analyses.
Avoiding political analysis and prescriptions, however, is like a clinician diagnosing a disease but not prescribing a treatment to resolve it. In the United States during the conservative 1980s, there were epidemiologists who thought epidemiology should not deal with policies. This position, fortunately, has since been discredited. But, epidemiology and public health should go one step further, since it is impossible to study policies (and evaluate policies) without understanding politics. I am glad that Prof. Ken Judge and I agree on this point.
CiteULike 
Connotea 
Del.icio.us What's this?
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||