Journal of Public Health Policy

, Volume 29, Issue 3, pp 275–289 | Cite as

Epidemiology and the Macrosocial Determinants of Health

  • Sara Putnam
  • Sandro Galea


In the past two decades, public health researchers have taken renewed interest in investigating the role of social factors in health. This holds substantial promise in terms of identifying manipulable social factors that are amenable to policy intervention. Most existing empirical and conceptual epidemiologic work, however, has focused on the more proximal social determinants, such as interpersonal relations. These factors, although perhaps easier to study epidemiologically, are much less relevant to policy makers than more “macrosocial” factors such as taxation policies. Limited epidemiologic attention to macrosocial determinants of health is ironic given that macrosocial factors such as the rapid industrialization and urbanization in the 19th century contributed to the organization of public health practice and, tangentially, to academic public health research. We suggest here that greater investment in the study of macrosocial determinants has the potential to make a significant and unique contribution to the greater public health agenda and should be a prominent aspect of social epidemiologic inquiry in the coming decades.


social determinants public health epidemiologic methods 


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Copyright information

© Palgrave Macmillan Ltd 2008

Authors and Affiliations

  1. 1.Center for Urban Epidemiologic Studies, New York Academy of MedicineNew YorkUSA
  2. 2.Department of EpidemiologyCenter for Social Epidemiology and Population Health, University of Michigan School of Public HealthAnn ArborUSA
  3. 3.Department of EpidemiologyColumbia University Mailman School of Public HealthNew YorkUSA

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