The study of ableism in population health: a critical review.

Over the past three decades, health equity has become a guiding framework for documenting, explaining, and informing the promotion of population health. With these developments, scholars have widened public health's aperture, bringing systems of oppression sharply into focus. Additionally, some researchers in disability and health have advocated for utilizing socially grounded frameworks to investigate the health of disabled people. Yet, naming ableism, much less operationalizing it for the empirical study of health, remains scant. This paper critically reviews the study of ableism as a social determinant of disabled people's health within population health research. First, we provide an orientation to the present state of this literature by looking to the past. We briefly trace a history of traditional approaches to studying disability and health and alternatives that have emerged from critiques of the individualized lens that has dominated this work. Next, we delineate the operation of ableism across social levels. We characterize how ableism has been studied in population health in terms of levels of analysis (intrapersonal, interpersonal, institutional, and structural) and measures of interest. To conclude, we discuss hinderances to and promising avenues toward population health research that advances health equity for disabled people.

Uses of theory in racial health disparities research: a scoping review and application of public health critical race praxis.

PURPOSE: Given the persistence of racial health disparities, scholars have called for investigations into structural origins of health inequity and deeper engagement with theory. We systematically assessed uses of theory-including theory informed conceptualizations of race and ethnicity, social structure, and racial hierarchy-in epidemiology and other quantitative population health literature on racial health disparities. METHODS: We conducted a scoping review of systematically identified original research articles (n=650) that sought to explain racial health disparities; articles were published in 17 high-impact epidemiology, public health, and social science journals. Trained coders abstracted data from each article. We applied Public Health Critical Race Praxis and an iterative data-charting method to identify key themes. RESULTS: Only 63 (9.7%) of 650 racial health disparities articles explicitly used theory. Among studies that engaged theory, one third (n=21/63) clearly conceptualized race and/or ethnicity, and a minority theorized social structure (n=19/63; 30%) and/or racial hierarchy as a structural relation (n=4/63; 6%). CONCLUSIONS: There is a pressing need for racial health disparities researchers to unambiguously use theory to conceptualize race and ethnicity in social and historical contexts and explain relational aspects of racial hierarchy. These approaches can better elucidate and inform action on structural determinants of both racial inequity and racial health inequity.

Seasonal differences in retinopathy-negative versus retinopathy-positive cerebral malaria.

Children with traditionally defined cerebral malaria (CM) can be subcategorized by the presence or absence of malaria retinopathy. We retrospectively reviewed the seasonal pattern of retinopathy status in patients admitted with CM in Blantyre, Malawi from 1997 to 2010. The proportion of children with CM who were retinopathy-positive was significantly greater during the peak seasonal rains when the community incidence of uncomplicated malaria is higher. This finding supports the hypothesis that retinopathy-negative and retinopathy-positive CM categories have different underlying etiologies.