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Since the beginning of the 20th century environmental health researchers have known about the association between toxicant exposure and disease. However, that knoweldge has not been well integrated into mainstream medicine. Shedding light on why is the focus of this chapter.

To shed light on this issue I analyze the 2011 American Academy of Pediatrics’ clinical practice guidelines for Attention Deficit/Hyperactivity Disorder (ADHD), focusing specifically on the omission of environmental health research pertaining to ADHD symptoms and exposures, such as lead and mercury.

I found that while environmental researchers have been documenting the link between lead and ADHD for over forty years, the American Academy of Pediatrics has completely omitted this research from its 2012 clinical practice guidelines. Moreover, I argue this omission can be traced to competitive pressures to protect medical jurisdiction, and a reductionist worldview that emphasizes treatment over prevention.

This is the first attempt to analyze the way clinical practice guidelines help reinforce and perpetuate dominant medical perspectives. Moreover, to shed explanatory light, this chapter offers a synthetic explanation that combines materialist and ideological factors.

Beyond the specific case of ADHD, this chapter has implications for understanding how and why environmental health research is omitted from other materials produced by mainstream medicine, such as materials found in the medical school curriculum, continuing medical education, medical journals, and on the medical association web sites.

Health social movements address several issues: (a) access to, or provision of, health care services; (b) disease, illness experience, disability and contested illness; and/or (c) health inequality and inequity based on race, ethnicity, gender, class and/or sexuality. These movements have challenged a variety of authority structures in society, resulting in massive changes in the health care system. While many other social movements challenge medical authority, a rapidly growing type of health social movement, “embodied health movements” (EHMs), challenge both medical and scientific authority. Embodied health movements do this in three ways: (1) they make the body central to social movements, especially with regard to the embodied experience of people with the disease; (2) they typically include challenges to existing medical/scientific knowledge and practice; and (3) they often involve activists collaborating with scientists and health professionals in pursuing treatment, prevention, research, and expanded funding. We present a conceptual framework for understanding embodied health movements as simultaneously challenging authority structures and allying with them, and offer the environmental breast cancer movement as an exemplar case.

Epidemiology is often described as “the basic science of public health” (Savitz, Poole & Miller, 1999; Syme & Yen, 2000). This description suggests both a close association with public health practice, and the separation of “pure” scientific knowledge from its application in the messy social world. Although the attainability of absolute objectivity is rarely claimed, epidemiologists are routinely encouraged to “persist in their efforts to substitute evidence for faith in scientific reasoning” (Stolley, 1985, p. 38) and reminded that “public health decision makers gain little from impassioned scholars who go beyond advancing and explaining the science to promoting a specific public health agenda” (Savitz et al., 1999, p. 1160). Epidemiology produces authoritative data that are transformed into evidence which informs public health. Those data are authoritative because epidemiology is regarded as a neutral scientific enterprise. Because its claims are grounded in science, epidemiological knowledge is deemed to have “a special technical status and hence is not contestable in the same way as are say, religion or ethics” (Lock, 1988, p. 6). Despite the veneer of universality afforded by its scientific pedigree, epidemiology is not a static or monolithic discipline. Epidemiological truth claims are embodied in several shifting paradigms that span the life of the discipline. Public health knowledges and practices, competing claims internal and external to epidemiology, and structural conditions (such as current political economies, material technologies, and institutions) provide important contexts in which certain kinds of epidemiological knowledge are more likely to emerge.

Scholars and activists working both within and outside the massive health-related machinery of government and the private sector and within and outside communities of color address the same fundamental questions: Why do health disparities exist? Why have they persisted over such a long time? What can be done to significantly reduce or eliminate them?

The purpose of this chapter is to offer reflections on conventional theories concerning causes and determinants of diseases. It also intends to examine both theoretical and empirical bases for adopting an Integrated Social-Ecological Systems (ISES) lens as a tool for understanding complexities related to drivers, determinants and causes of diseases.

We assessed the theoretical underpinnings of a range of historical and contemporary lenses for viewing infectious disease drivers and the implications of their use when used to explain both personal (i.e. individual) and population health. We examined these issues within the empirical context of the City of Dhaka (Bangladesh) by adopting an ISES lens. Within this study an emphasis has been placed on illustrating how feedback loops and non-linearity functions in systems have a direct bearing upon various aspects of infectious disease occurrences.

A brief triumph over microbes during the last century stemmed in part from our improved understanding of disease causation which was built using disciplinary-specific, monocausal approaches to the study of disease emergence. Subsequently, empirical inquiries into the multi-factorial aetiology and the ‘web of causation’ of disease emergence have extended frameworks beyond simplistic, individualistic descriptions of disease causation. Nonetheless, much work is yet to be done to understand the roles of complex, intertwined, multi-level, social-ecological factors in affecting disease occurrence. We argue, a transdisciplinary-oriented, ISES lens is needed to explain the complexities of disease occurrence at various and interacting levels. More theoretical and empirical formulations, with evidence derived from various parts of the world, is also required to further the debate.

Our study advances the theoretical as well as empirical basis for considering an integrated human-nature systems approach to explaining disease occurrence at all levels so that factors at the individual, household/neighbourhood, local, regional and global levels are not treated in isolation.

Understanding of the effects of formal education on HIV/AIDS infection in South Saharan Africa (SSA) has been a complex task because consecutive waves of research offer different, seemingly contradictory results and explanations of what exactly are the schooling effects on HIV/AIDS and the causal mechanisms driving those effects. This chapter concentrates on the narrative and implications of the key substantive findings from a multidisciplinary scientific team that was formed to explore the precise nature of the relationship between population education and the HIV/AIDS pandemic in SSA and to determine the main causal mechanisms behind the association. As members of this team, this chapter reviews and synthesizes our technical demographic, epidemiological, and health research. This, and other relevant research, suggests that, like in other cases of education and health risk, because of a historical change in the public health and information environment during the pandemic there was a shift in which outcomes of education dominated individual's sexual and disease prevention behavior. The SSA HIV/AIDS case is thoroughly examined, and then used to bridge to a general discussion of the effects of educational development on population health.

Food system channels are proposed to be major components of the larger food system which influence health and illness.

Food system channels are defined, discussed in relationship to other food system components, considered in terms of historical food system changes, examined in relationship to wellbeing and disease, and proposed to have useful applications.

Food system channels are broad, organized, and integrated pathways through which foods and nutrients pass. Channels are larger in scale and scope than previously described food system structures like chains, stages, sectors, networks, and others. Four major types of contemporary Western food system channels differ in their underlying values and health impacts. (1) Industrialized food channels are based on profit as an economic value, which contributes to a diversity of inexpensive foods and chronic diseases. (2) Emergency food channels are based on altruism as a moral value, and try to overcome gaps in industrialized channels to prevent diseases of poverty. (3) Alternative food channels are based on justice and environmentalism as ethical values, and seek to promote wellness and sustainability. (4) Subsistence food channels are based on self-sufficiency as a traditional value, and seek self-reliance to avoid hunger and illness. Historical socioeconomic development of agricultural and industrial transitions led to shifts in food system channels that shaped dietary, nutritional, epidemiological, and mortality transitions.

Food system channels provide varying amounts of calories and types of nutrients that shape wellbeing and diseases. Sociologists and others may benefit from examining food system channels and considering their role in health and illness.

Depressive disorder has been defined by increasingly specific neurophysiological mechanisms and features during the past two decades. At the same time, depression has grown into an epidemic proportion and become a major public health problem. Consequently, the scope of depressive experience and conduct has also widened and the meaning of depression has multiplied and become equivocal. This chapter analyses how this tension is handled in current Western mental health care. The focus of the study is the role of neuroscientific views in mental health reasoning and practice. The empirical case is the mental health discussion in Finland from the late 1980s to the present day. The analysis of the historical change in understandings of depression in Finnish psychiatry and mental health care provides a view of the relevance of neuroscientific models in defining depressive illness and outlining diagnostic and treatment practices. Moreover, the analysis brings forth the relationship of neuroscientific concepts to other ways of defining depression – epidemiology, diagnostic classification, psychodynamic and other psychological theories – within clinical reasoning. A conclusion to be drawn from the analysis of the Finnish case is that neurobiological concepts of depression have only limited influence on the ways in which the disorder is conceived within the practical context of mental health care. It seems that the idea of depression as a multi-factorial disorder remains a good enough conceptual framework for clinical practice. Even the influence of neurosciences on treatment is still somewhat marginal. Within current practices of depression management, it is not the brain that is treated but risks, symptoms, and persons.

Purpose – To examine the influence of changing diagnostic tools and the pharmaceutical and health insurance industries' practices on perceptions of depression prevalence in the late 20th and early 21st centuries.

Approach – This is a general review of the sociohistorical shifts in depression diagnosis and pharmaceutical and health insurance industry practices during this time period as they impact professional and lay perceptions of changes in depression prevalence.

Findings – Shifts in the definition of depression to an increasingly medically oriented, social context-free definition along with the interaction of the pharmaceutical industry, health care, and health insurance industries in the U.S. system of mental health care have become major organizers of professional and lay perceptions of the nature of depression, its treatment, and prevalence. These sociohistorical and economic influences need to be factored into debates on depression prevalence.

Contribution of paper to the field – This chapter provides an introductory-level synthesis of basic psychiatric epidemiology concepts and social science critiques of professional and lay perceptions of depression prevalence as “epidemic.”