We believe that shifting the language to explicitly focus on "social determination" rather than "social determinants" will help keep the focus where it belongs to better promote pathways to health for all.
Joining colleagues from the Global North who also call for more comprehensively concentrating on systemic power relations (e.g. [ 2- 4]), researchers from the Global South have been arguing for shifting our attention to social processes (e.g. [ 16]), and indeed shifting our language from "social determinants" to the processes of the "social determination" of health [SDnH] ([ 17- 20]).
Our research programme includes a team of researchers and knowledge users in Ecuador (Breilh 2011) who have prioritized an epistemology focusing on the critical processes that influence the social determination of health, more so than on the pathways where various social determinants can be observed (Breilh 2008, 2011; Breilh et al. 2014).
Our experience illustrates that we do indeed need a sharper theoretical focus in guiding empirically-rich intervention research, but this theory must look not at discrete social determinants of health, but rather to comprehend and then address the critical processes of social determination that systemically drive disparities.
The social determination of health is much more than a collection of fragmented and isolated "determinants" that, from a reductionist viewpoint, [is] associated with classic risk factors and individual lifestyles.
The context of that dissertation provides a striking exemplar of the social determination of science.
Feminist postmodernists criticize feminist empiricists for presuming the existence of an individual, transhistorical subject of knowledge outside of social determination (Harding 1990).
We therefore decided to explore how social circus can influence the social determination of health.
It can help us recognize how place, time, environment, and context form the social determination of health.
