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eHealth Solutions for Healthcare Disparities pp 129–144Cite as

Beyond Traditional Paradigms in Disparities Research

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Recently several researchers have hypothesized pathways that attempt to explain how the sociobehavioral environment is related to health and health disparities (Acheson, 1998; Adler & Ostrove, 1999; Baum, Garofalo, & Yali, 1999; Birch, 1999; Capitman, Bhalotra, Calderon-Rosado, & Gibbons, 2003; Fuhrer et al., 2002; Macintyre, 1997; Macintyre, Ellaway, & Cummins, 2002; Williams, 1999). Historically these conceptual frameworks have formed a solid foundation upon which science has been built. Upon review of these frameworks, it is possible to make at least three general observations. The first is the lack of depth to which they integrate our present understanding of the biology of disease, particularly at the cellular and molecular levels. With the exception of those pathways based on stress (neuroimmunological) mechanisms, the published frameworks in the behavioral sciences and epidemiological literature largely lack clearly stated, causal biologic connections to observed health outcomes (Acheson; Adler & Ostrove; Evans & Stoddart, 1990; LaLonde, 1981; Macintyre; Williams). On the other hand, the biologically oriented formulations poorly account for socioenvironmental and behavioral effect modifiers that may affect the pathogenesis of disease and the development of health disparities (Burger & Gimelfarb, 1999; Meyer & Breitner, 1998; Phillips & Belknap, 2002; Sharma, 1998).

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Authors and Affiliations

  1. Johns Hopkins Urban Health Institute (UHI), 21205, Baltimore, MD, USA

    Associate Director Michael Christopher Gibbons MD, MPH

  2. Johns Hopkins School of Medicine, Johns Hopkins Oncology Center, Baltimore, MD, USA

    Malcolm Brock MD & Stephen Baylin MD

  3. Johns Hopkins Bloomberg School of Public Health, Johns Hopkins Oncology Center, Baltimore, MD, USA

    Anthony J. Alberg PhD

  4. Johns Hopkins Bloomberg School of Public Health, Johns Hopkins Bloomberg School of Public Health Center on Aging and Health, Baltimore, MD, USA

    Thomas Glass PhD

  5. Johns Hopkins Bloomberg School of Public Health, Johns Hopkins Center for Health Disparities Solutions, Baltimore, MD, USA

    Thomas A. LaVeist PhD

  6. Johns Hopkins School of Medicine, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    David Levine MD, MPH, ScD

  7. Johns Hopkins Urban Health Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    C. Earl Fox MD, MPH

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  1. Associate Director Michael Christopher Gibbons MD, MPH
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    Michael Christopher Gibbons MD, MPH

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Gibbons, M.C. et al. (2008). Beyond Traditional Paradigms in Disparities Research. In: Gibbons, M.C. (eds) eHealth Solutions for Healthcare Disparities. Springer, New York, NY. https://doi.org/10.1007/978-0-387-72815-5_12

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