title: [Four axiological considerations in social epidemiology for the monitoring of health inequality].
abstract: As the conceptual components of the most important contemporary public health agendas at the global and regional levels are brought into alignment and as it becomes more clearly understood that equity is a constitutive principle of these agendas, there is also a growing awareness of the strategic value of monitoring social inequalities in health. This is the health intelligence tool par excellence, not only for objectively assessing progress towards achieving health equity, but also for reporting action on the social determinants of health, progress towards the attainment of health for all, and the success of intersectoral efforts that take a "health in all policies" approach. These transformations are taking place in the context of an increasingly evident paradigm shift in public health. This essay presents four axiological considerations inherent to-and essential for -conceptualizing and implementing ways to measure and monitor health inequalities: ecoepidemiology as an emerging field in contemporary public health; the determinants of health as the causal model and core of the new paradigm; the relationship between the social hierarchy and health to understand the health gradient; and the practical need for a socioeconomic classification system that captures the social dimension in the determinants of health. The essay argues that these four axiological considerations lend epidemiologic coherence and rationality to the process of measuring and monitoring health inequalities and, by extension, to the development of pro-equity health policy proposals.
authors.affiliation: Programa Especial de Desarrollo Sostenible y Equidad en Salud, Organización Panamericana de la Salud, Washington, D.C., Estados Unidos de América, mujicaos@paho.org.
authors.forename: Oscar J
authors.initials: OJ
authors.lastname: Mújica
mesh_terms: D006291:Health Policy; D054624:Health Status Disparities; D006801:Humans; D012959:Socioeconomic Factors