A two-day conference, “Deep Wounds: Social Determinants of Health Inequality,” brought together an interdisciplinary group of scholars who take innovative approaches to studying the social foundations of health inequalities across the United States, Nov. 8-9 at the Statler Hotel.
“America’s population health crisis is often portrayed primarily as a drug and despair problem for low-educated midlife whites in rural and small town areas,” said Robert Hummer, the Howard W. Odum Distinguished Professor of Sociology at the University of North Carolina at Chapel Hill, whose keynote address focused on the wide-ranging causes of a downturn in American life expectancy. “I argue that it is deeper, broader, more demographically diverse, more epidemiologically complex and more institutionalized than what the media portrays and what most policy makers are working on.”
Hosted by Cornell’s Center for the Study of Inequality and cosponsored by the Cornell Population Center and the Cornell Center for Health Equity, the conference built on the idea that individuals are embedded within multiple contexts – geographic, physical, social and policy – that influence health.
Academics at the conference represented eight disciplines including sociology, economics, public policy and public health, to generate dialogue about the interrelated causes of the social patterning of health and reducing observed inequalities in health outcomes.
Participants sought to explore the social determinants of health and health-producing behaviors, and to identify the policy levers through which they might be mitigated. Panels examined the role domains such as neighborhood, housing, social networks and work play in health.
William Hobbs, assistant professor of human development, said social networks are important for health, and loneliness increasingly is becoming an issue. He pointed to research findings that suggested online social integration is linked to better health outcomes. “The results show that receiving friend requests online is associated with reduced mortality but initiating friendships is not,” Hobbs said. “Additionally, online behaviors that indicate face-to-face social activity, such as posting photos, are associated with reduced mortality.”
Hobbs said this research may be an important step in understanding how, on a global scale, online social networks might be adapted to improve modern populations’ social and physical health.
Experts also considered exposure to structural racism, discrimination and stress; choices about health behaviors, including diet and exercise; and examined how health outcomes evolve across the life course.
Elaine Wethington, professor of human development and sociology, said nearly half of all adults in the U.S. aged 65 and older have chronic pain, and the “majority of people who have chronic pain are undertreated or ineffectively treated,” she said.
“The Life Course Perspective is a theoretical perspective for studying lives as they unfold over time that is increasingly applied to studying health and health behavior that integrates findings about health disparities from many different disciplines,” she said.
Wethington noted few researchers who study pain use social science perspectives, as opposed to medical or physiological ones, but there are benefits in doing so.
“Incorporation of life history into pain intervention development, and subsequent translation into practice, may be improved by including additional insights from attention to life-course transitions, social determinants and critical periods of development where health trajectories are set in motion,” she said.
For Hummer, it’s the duty of academics and researchers who dedicate their lives to understanding these issues to help inform public policy and the public itself.
“We need to change the emphasis from individuals and medicine to institutional and social policy oriented” perspectives, he said. “There is a lot more we can do in terms of publicizing the kinds of issues we have ongoing here and not limiting it to the opioid crisis and middle-aged plights in men mainly in rural areas.”
The conference was organized by associate professors of sociology Erin York Cornwell and Vida Maralani.
Stephen D’Angelo is assistant director of communications in the College of Human Ecology