Research project "Causality and Social Determinants of Health and Illness" funded by the National Science Centre, Poland under the OPUS programme, nr UMO-2023/49/B/HS1/00176; 30 October 2024 – 29 October 2027 Principal investigator: Elena Popa, PhD

Basic information

• Project title: Causality and Social Determinants of Health and Illness
• Duration: 30 October 2024 – 19 September 2025
• PI: Elena Popa PhD

Opis popularyzatorski

In current medical practice, the concepts of health and disease are understood mainly in biological terms. While there is a history of investigating how social conditions or psychological factors influence health and illness, models incorporating the biological, psychological, and social aspects have been criticized for their vagueness. Recent work in philosophy has pointed out that medical research on social determinants of health and illness is a good illustration of how these factors come together. At the same time, this research has not been sufficiently investigated from a philosophical point of view. Notably, the research has highlighted the need to move beyond a reductive ontology that explains disease causation in terms of physical or chemical processes. This project aims to further develop this picture by investigating how current concepts of causation apply to social determinants of health and illness. The recent literature on causation broadly distinguishes difference-making, mechanistic, and dispositional accounts and corresponding concepts of causation. All of these concepts are important in spelling out whether a social or psychological variable causes a disease, how two such variables are causally related, and what it means to say that a social or psychological variable predisposes one to various health problems. This is important in light of persistent criticism regarding the excessive focus on biomedical interventions in healthcare or health promotion. A clear account of how causality operates between social, psychological, and biological factors can help frame policies for health promotion or communicate health risks in a way that moves beyond assumptions reducing causality to physical or chemical processes. The project will first explore ethical reasons for including social and psychological variables in causal models for health contexts, showing how these models can still meet objectivity standards. Afterward, the three main sets of approaches to causality will be investigated in relation to social determinants of health within a pluralist framework. Lastly, the project will investigate case studies from psychiatry and public health. The main examples to be discussed concern the health effects of inequality and the causal connection between agency and health.

Dissemination results include presentations to a research seminar and a conference as follows:

1. ‘Why Specifying Causal Pathways Featuring Social Determinants of Health Matters for Public Health Ethics’ (with J. Zameska), Philosophy of Public Health Workshop, University of South Bohemia, November 22 2024, Czechia.

2. ‘Why Specifying Causal Pathways Featuring Social Determinants of Health Matters for Public Health Ethics’ (with J. Zameska), Institute of Philosophy, Czech Academy of Sciences, November 21 2024, Czechia (invited).

3. ‘Handling Disagreement in Vaccine Research: From Trustworthy Experts to Trustworthy Institutions’, the 8th Panhellenic Conference on Philosophy of Science, Athens, Greece.