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Published in: BMC Public Health 1/2019

Open Access 01-12-2019 | Correspondence

Developing a critical realist informed framework to explain how the human rights and social determinants of health relationship works

Authors: Fiona Haigh, Lynn Kemp, Patricia Bazeley, Neil Haigh

Published in: BMC Public Health | Issue 1/2019

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Abstract

Background

That there is a relationship between human rights and health is well established and frequently discussed. However, actions intended to take account of the relationship between human rights and social determinants of health have often been limited by lack of clarity and ambiguity concerning how these rights and determinants may interact and affect each other. It is difficult to know what to do when you do not understand how things work. As our own understanding of this consideration is founded on perspectives provided by the critical realist paradigm, we present an account of and commentary on our application of these perspectives in an investigation of this relationship.

Findings

We define the concept of paradigm and review critical realism and related implications for construction of knowledge concerning this relationship. Those implications include the need to theorise possible entities involved in the relationship together with their distinctive properties and consequential power to affect one another through exercise of their respective mechanisms (ways of working). This theorising work enabled us identify a complex, multi-layered assembly of entities involved in the relationship and some of the array of causal mechanisms that may be in play. These are presented in a summary framework.

Conclusion

Researchers’ views about the nature of knowledge and its construction inevitably influence their research aims, approaches and outcomes. We demonstrate that by attending to these views, which are founded in their paradigm positioning, researchers can make more progress in understanding the relationship between human rights and the social determinants of health, in particular when engaged in theorizing work. The same approaches could be drawn on when other significant relationships in health environments are investigated.
Literature
1.
go back to reference Rights UNCoH. Human rights and transnational corporations and other business enterprises resolution 2005/69 (20 April 2005) Para 1(d). In. Geneva: Office of the United Nations High Commissioner for Human Rights; 2005. Rights UNCoH. Human rights and transnational corporations and other business enterprises resolution 2005/69 (20 April 2005) Para 1(d). In. Geneva: Office of the United Nations High Commissioner for Human Rights; 2005.
2.
go back to reference Hunt P. Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, Report of the Special Rapporteur, Paul Hunt, submitted in accordance with commission resolution 2002/31. UN Doc. E/CN.4/2003/58. (Februuary 13 2003) paras 82-85. Hunt P. Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, Report of the Special Rapporteur, Paul Hunt, submitted in accordance with commission resolution 2002/31. UN Doc. E/CN.4/2003/58. (Februuary 13 2003) paras 82-85.
3.
go back to reference ICESCT. Concluding Observations on the United Kingdom, UN Doc E/C.12/1/Add. 19 (4th December 1997) para 33. ICESCT. Concluding Observations on the United Kingdom, UN Doc E/C.12/1/Add. 19 (4th December 1997) para 33.
4.
go back to reference Chapman AR. Evaluating the health-related targets in the sustainable development goals from a human rights perspective. The International Journal of Human Rights. 2017;21(8):1098–113.CrossRef Chapman AR. Evaluating the health-related targets in the sustainable development goals from a human rights perspective. The International Journal of Human Rights. 2017;21(8):1098–113.CrossRef
5.
go back to reference Chapman A. The social determinants of health, health equity, and human rights. Health and Human Rights. 2010;12(2):17–30.PubMed Chapman A. The social determinants of health, health equity, and human rights. Health and Human Rights. 2010;12(2):17–30.PubMed
6.
go back to reference Hunt P. Missed opportunities: Human rights and the Commission on Social Determinants of Health. Global Health Promotion. 2009;(Supp 1):36–41. Hunt P. Missed opportunities: Human rights and the Commission on Social Determinants of Health. Global Health Promotion. 2009;(Supp 1):36–41.
7.
go back to reference Schrecker T, Chapman AR, Labonté R, De Vogli R. Advancing health equity in the global marketplace: how human rights can help. Soc Sci Med. 2010;71(8):1520–6.CrossRef Schrecker T, Chapman AR, Labonté R, De Vogli R. Advancing health equity in the global marketplace: how human rights can help. Soc Sci Med. 2010;71(8):1520–6.CrossRef
8.
go back to reference Rasanathan K, Norenhag J, Valentine N. Realizing human rights-based approaches for action on the social determinants of health. Health and Human Rights. 2010:12(2). Rasanathan K, Norenhag J, Valentine N. Realizing human rights-based approaches for action on the social determinants of health. Health and Human Rights. 2010:12(2).
9.
go back to reference Price L. Wellbeing research and policy in the U.K.: questionable science likely to entrench inequality. Journal of Critical Realism. 2017;16(5):451–67.CrossRef Price L. Wellbeing research and policy in the U.K.: questionable science likely to entrench inequality. Journal of Critical Realism. 2017;16(5):451–67.CrossRef
10.
go back to reference Price L. Critical realist versus mainstream Interdisciplinarity. Journal of Critical Realism. 2014;13(1):52–76.CrossRef Price L. Critical realist versus mainstream Interdisciplinarity. Journal of Critical Realism. 2014;13(1):52–76.CrossRef
11.
go back to reference Bhaskar R, Danermark B. Metatheory, interdisciplinarity and disability research: a critical realist perspective. Scand J Disabil Res. 2006;8(4):278–97.CrossRef Bhaskar R, Danermark B. Metatheory, interdisciplinarity and disability research: a critical realist perspective. Scand J Disabil Res. 2006;8(4):278–97.CrossRef
12.
go back to reference Carter S, Little M. Justifying knowledge, justifying method, taking action: epistemologies, methodologies, and methods in qualitative research. Qual Health Res. 2007;17(10):1316–28.CrossRef Carter S, Little M. Justifying knowledge, justifying method, taking action: epistemologies, methodologies, and methods in qualitative research. Qual Health Res. 2007;17(10):1316–28.CrossRef
13.
go back to reference MacNaughton G, Haigh F, Mcgill M, Koutsioumpas K, Sprague C. The impact of human rights on universalizing health Care in Vermont, USA. Health and Human Rights Journal. 2015;17(2):83–95. MacNaughton G, Haigh F, Mcgill M, Koutsioumpas K, Sprague C. The impact of human rights on universalizing health Care in Vermont, USA. Health and Human Rights Journal. 2015;17(2):83–95.
14.
go back to reference Invernizzi-Accetti C. Reconciling legal positivism and human rights: Hans Kelsen's argument from relativism. Journal of Human Rights. 2018;17(2):215–28.CrossRef Invernizzi-Accetti C. Reconciling legal positivism and human rights: Hans Kelsen's argument from relativism. Journal of Human Rights. 2018;17(2):215–28.CrossRef
15.
go back to reference Guba E, Lincoln Y. Fourth generation evaluation. California and London: Sage Publications; 1989. Guba E, Lincoln Y. Fourth generation evaluation. California and London: Sage Publications; 1989.
16.
go back to reference The SAGE. Handbook of the philosophy of social sciences. In London. 2011. The SAGE. Handbook of the philosophy of social sciences. In London. 2011.
17.
go back to reference Coleman JL, Himma KE. In: Shapiro SJ, editor. the Oxford handbook of jurisprudence and philosophy of law. Oxford: OUP Oxford; 2012. Coleman JL, Himma KE. In: Shapiro SJ, editor. the Oxford handbook of jurisprudence and philosophy of law. Oxford: OUP Oxford; 2012.
19.
go back to reference Sayer A. Realism and social science. London: Sage; 2000. Sayer A. Realism and social science. London: Sage; 2000.
20.
go back to reference Danermark B, Ekstrom L, Jakobsen L, Karlsson JC. Explaining society: critical realism and the social sciences. London and New York: Routledge; 2002. Danermark B, Ekstrom L, Jakobsen L, Karlsson JC. Explaining society: critical realism and the social sciences. London and New York: Routledge; 2002.
21.
go back to reference Bhaskar R. A realist theory of science. New York: Routledge; 2008. Bhaskar R. A realist theory of science. New York: Routledge; 2008.
22.
go back to reference Harris P, Sainsbury P, Kemp L. The fit between health impact assessment and public policy: practice meets theory. Soc Sci Med. 2014;108:46–53.CrossRef Harris P, Sainsbury P, Kemp L. The fit between health impact assessment and public policy: practice meets theory. Soc Sci Med. 2014;108:46–53.CrossRef
23.
go back to reference Clark AM. What are the components of complex interventions in healthcare? Theorizing approaches to parts, powers and the whole intervention. Soc Sci Med. 2013;93:185–93.CrossRef Clark AM. What are the components of complex interventions in healthcare? Theorizing approaches to parts, powers and the whole intervention. Soc Sci Med. 2013;93:185–93.CrossRef
24.
go back to reference Scambler G, Scambler S. Theorizing health inequalities: the untapped potential of dialectical critical realism. Soc Theory Health. 2015;13(3–4):340–54.CrossRef Scambler G, Scambler S. Theorizing health inequalities: the untapped potential of dialectical critical realism. Soc Theory Health. 2015;13(3–4):340–54.CrossRef
25.
go back to reference Danermark B. Interdisciplinary research and critical realism. The example of disability research. Journal of Critical Realism. 2002:5. Danermark B. Interdisciplinary research and critical realism. The example of disability research. Journal of Critical Realism. 2002:5.
26.
go back to reference Pawson R. The science of evaluation: a realist manifesto. London: Sage; 2013.CrossRef Pawson R. The science of evaluation: a realist manifesto. London: Sage; 2013.CrossRef
27.
go back to reference Baum F, Delany-Crowe T, MacDougall C, van Eyk H, Lawless A, Williams C, Marmot M. To what extent can the activities of the south Australian health in all policies initiative be linked to population health outcomes using a program theory-based evaluation? BMC Public Health. 2019;19(1):88.CrossRef Baum F, Delany-Crowe T, MacDougall C, van Eyk H, Lawless A, Williams C, Marmot M. To what extent can the activities of the south Australian health in all policies initiative be linked to population health outcomes using a program theory-based evaluation? BMC Public Health. 2019;19(1):88.CrossRef
28.
go back to reference Jagosh J, Bush PL, Salsberg J, Macaulay AC, Greenhalgh T, Wong G, Cargo M, Green LW, Herbert CP, Pluye P. A realist evaluation of community-based participatory research: partnership synergy, trust building and related ripple effects. BMC Public Health. 2015;15(1):725.CrossRef Jagosh J, Bush PL, Salsberg J, Macaulay AC, Greenhalgh T, Wong G, Cargo M, Green LW, Herbert CP, Pluye P. A realist evaluation of community-based participatory research: partnership synergy, trust building and related ripple effects. BMC Public Health. 2015;15(1):725.CrossRef
29.
go back to reference Kramer D, Harting J, Kunst AE. Understanding the impact of area-based interventions on area safety in deprived areas: realist evaluation of a neighbour nuisance intervention in Arnhem, the Netherlands. BMC Public Health. 2016;16(1):291.CrossRef Kramer D, Harting J, Kunst AE. Understanding the impact of area-based interventions on area safety in deprived areas: realist evaluation of a neighbour nuisance intervention in Arnhem, the Netherlands. BMC Public Health. 2016;16(1):291.CrossRef
30.
go back to reference Sayer A. Method in social science: a realist approach (2nd Ed). Abingdon: Routledge; 1992. Sayer A. Method in social science: a realist approach (2nd Ed). Abingdon: Routledge; 1992.
31.
go back to reference Forbes A, Wainwright SP. On the methodological, theoretical and philosophical context of health inequalities research: a critique. Soc Sci Med. 2001;53(6):801–16.CrossRef Forbes A, Wainwright SP. On the methodological, theoretical and philosophical context of health inequalities research: a critique. Soc Sci Med. 2001;53(6):801–16.CrossRef
32.
go back to reference Scott-Samuel A, O'Keefe E. Health impact assessment, human rights and global public policy: a critical appraisal. Bull World Health Organ. 2007;85(3):212–7.CrossRef Scott-Samuel A, O'Keefe E. Health impact assessment, human rights and global public policy: a critical appraisal. Bull World Health Organ. 2007;85(3):212–7.CrossRef
33.
go back to reference Bhaskar R, Frank C, Hoyer KG, Naess P. In: Parker J, editor. Interdisciplinarity and climate change: transforming knowledge and practice for our global future. London and New York: Routledge; 2010.CrossRef Bhaskar R, Frank C, Hoyer KG, Naess P. In: Parker J, editor. Interdisciplinarity and climate change: transforming knowledge and practice for our global future. London and New York: Routledge; 2010.CrossRef
34.
go back to reference Alderson P. The politics of childhoods real and imagined volume 2: practical application of critical realism to childhood studies. London and New York: Routledge; 2016. Alderson P. The politics of childhoods real and imagined volume 2: practical application of critical realism to childhood studies. London and New York: Routledge; 2016.
35.
36.
go back to reference Alderson P. International human rights, citizenship education, and critical realism. Lond Rev Educ. 2016;14(3):3–12. Alderson P. International human rights, citizenship education, and critical realism. Lond Rev Educ. 2016;14(3):3–12.
37.
go back to reference London L, Schneider H. Globalisation and health inequalities: can a human rights paradigm create space for civil society action? Soc Sci Med. 2012;74(1):6–13.CrossRef London L, Schneider H. Globalisation and health inequalities: can a human rights paradigm create space for civil society action? Soc Sci Med. 2012;74(1):6–13.CrossRef
38.
go back to reference Tress G, Tress B, Fry G. Clarifying integrative research concepts in landscape ecology. Landscape Ecology. 2005;20(4):479–93.CrossRef Tress G, Tress B, Fry G. Clarifying integrative research concepts in landscape ecology. Landscape Ecology. 2005;20(4):479–93.CrossRef
39.
go back to reference O'Cathain A, Murphy E, Nicholl J. Multidisciplinary, interdisciplinary, or dysfunctional? Team working in mixed-methods research. Qual Health Res. 2008;18(11):1574–85.CrossRef O'Cathain A, Murphy E, Nicholl J. Multidisciplinary, interdisciplinary, or dysfunctional? Team working in mixed-methods research. Qual Health Res. 2008;18(11):1574–85.CrossRef
40.
go back to reference Alderson P. Childhoods real and imagined: volume 1: an introduction to critical realism and childhood studies (ontological explorations). London and New York: Routledge; 2013.CrossRef Alderson P. Childhoods real and imagined: volume 1: an introduction to critical realism and childhood studies (ontological explorations). London and New York: Routledge; 2013.CrossRef
41.
go back to reference Piven FF, Cloward RA. Power repertoires and globalization. Polit Soc. 2000;28(3):413–30.CrossRef Piven FF, Cloward RA. Power repertoires and globalization. Polit Soc. 2000;28(3):413–30.CrossRef
42.
go back to reference Huber M, Morreale S. Disciplinary styles in the scholarship of teaching and learning: exploring common ground. American Association for Higher Education and The Carnegie Foundation for the Advancement of Teaching: Washington; 2002. Huber M, Morreale S. Disciplinary styles in the scholarship of teaching and learning: exploring common ground. American Association for Higher Education and The Carnegie Foundation for the Advancement of Teaching: Washington; 2002.
Metadata
Title
Developing a critical realist informed framework to explain how the human rights and social determinants of health relationship works
Authors
Fiona Haigh
Lynn Kemp
Patricia Bazeley
Neil Haigh
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2019
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-019-7760-7

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