Colloquium: Nov 30 18


Speaker: Dr. Carina Fourie, University of Washington

Title: Discrimination, Emotion, and Health Inequities

Friday, November 30th at 2:30pm CLE A303




In this paper, I turn critical philosophical attention to a primary topic of public health research – the social determinants of health – connecting public health literature with theories of injustice. I critically assess a model of discrimination as a social determinant of health, arguing that the implications of this model can reinforce inequities, and I demonstrate how this criticism should help inform theories of health equity.

In the first section of the paper, I identify the discrimination-emotion-health model and its implications. This model details the way in which discrimination can affect emotions and in turn health. Racial discrimination, for example, functions not only to skew access to resources such as healthcare and opportunities for healthy living, it also creates stress and negative emotional states such as psychological distress which can in and of themselves be manifestations of ill-health, e.g. in the form of psychological ill-health, or they can increase the risk of physiological disease and impairment, or both. The discrimination-emotion-health model appears to underlie much public health literature on discrimination as a psychosocial determinant of health but is not made explicit.

In the second section I argue that an appreciation of the political dimensions of emotions, indicates that the model can have problematic implications, for example, reinforcing gender, class and racial stereotypes. I will provide a critique of the model focusing on six categories of concern: reinforcement, agency, respectability, dissidence, fragility of privilege and object of emotions.

In the final section, I will demonstrate how this critique helps us to develop the features required of a theory of health equity in order for such a theory to best represent discrimination as a psychosocial determinant of health. I highlight six implications of the critique for theories of health equity, including the recognition that health policies have expressive value, and that oppressive systems can damage the privileged, as well as the oppressed. Thinking about the model and its critique according to such a theory will provide health policy-makers and practitioners with a nuanced way of thinking about the role of emotions in health disparities. In turn, this can help with the development of suitable policies and guidance for reducing health inequities.