Dialectical frameworks address limitations in social determinants of health, suggesting new insights for health outcomes and social movements.
The social determinants of health (SDOH) framework has proven useful for research and practice in addressing the social causes of many health outcomes. However, its limitations may restrict its value as the world undergoes rapid ecological and social change. We argue that SDOH does not adequately incorporate rapidly changing or “far upstream” social processes (particularly social movements), the dialectics of social conflict and creative social innovation, or bidirectional causation. Ecosocial theory addresses some of these issues, yet dialectical frameworks offer additional insights during periods of rapid social change and disruption. The implications for research methods and practice are discussed. ( Am J Public Health. Published online ahead of print September 18, 2025:e1–e9. https://doi.org/10.2105/AJPH.2025.308239 )
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Friedman et al. (2025) studied this question.
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