To make long-term gains against infection inequity, infectious disease epidemiology needs to develop a more sociological imagination

social epidemiology
fundamental cause

Zelner JL, Naraharisetti R, Zelner S.



Abstract In a recent article in the Journal, Noppert et al. (Am J Epidemiol. 2023;192(3):475–482) articulated in detail the mechanisms connecting high-level “fundamental social causes” of health inequity to inequitable infectious disease outcomes, including infection, severe disease, and death. In this commentary, we argue that while intensive focus on intervening mechanisms is welcome and necessary, it cannot occur in isolation from examination of the way that fundamental social causes—including racism, socioeconomic inequity, and social stigma—sustain infection inequities even when intervening mechanisms are addressed. We build on the taxonomy of intervening mechanisms laid out by Noppert et al. to create a road map for strengthening the connection between fundamental cause theory and infectious disease epidemiology and discuss its implications for future research and intervention.