What do we mean by a critical perspective in public health?

This is not an easy question to answer, but happily there are some great resources to draw from in doing so.

One important resource is the international scholarly journal Critical Public Health, which provides a window into application of critical perspectives in public health and related fields, including how it has evolved over time. Since its inception in 1979 as Radical Community Medicine, the journal has been committed to ‘the politics of public health’ – as the editors highlighted in a 2004 editorial, which gives a hint of what is meant by a critical perspective.

In a 2008 volume showcasing work from the journal, Green and Labonté articulate the importance of a critical voice for public health (that is, a stance for uncovering the health damaging effects of particular social structures, in their political and historical contexts; and challenging those structures); as well as a critique of public health, which includes asking difficult questions about successes and failures, and constantly questioning our own taken-for-granted assumptions.

More recently, and consistent with a critical ‘for’ and ‘of’ public health stance, Bell and Green articulate roles for critical perspectives as including asking the ‘big questions’ facing public health; unsettling taken-for-granted concepts in the field; and turning the spotlight on public health practice itself.

In a 2021 Critical Public Health commentary, Schrecker helpfully itemises five key, intersecting elements that answer the question, ‘what is critical about critical public health?’ These are: (1) a normative commitment to health inequity as ethically indefensible; (2) the imperative to situate health inequities within their social arrangements or institutions, which themselves are highly invested in maintaining inequities; (3) relatedly; recognition that history matters; contemporary health inequities reflect inequities historically embedded in institutions and structures; (4) acknowledgement of the pernicious impact of medicalisation, which can serve to obscure large-scale social and political forces; and (5) recognition that the production of scientific knowledge is itself a social process, which must be situated in its broader contexts.

This summary is by Lindsay McLaren. A version will appear in a chapter in a forthcoming volume, Encyclopedia of Health Research in the Social Sciences (K. Dew and S. Donovan, Eds), Edward Elgar Publishing, 2023 (anticipated).