February 18, 2025

On January 15th, the UHC was honored to host Dr. Julia Lynch, a Professor of Political Science at the University of Pennsylvania and Co-Director of the Lauder Institute at Penn’s Wharton School of Business. Her work focuses on the politics of inequality, public health, and social policy in rich democracies, particularly Western European countries. Dr. Lynch's talk, “’Ye clouds, who are the ornaments of heaven’: Unpacking The Structural Determinants of Health", provided a glimpse into the current relationship between using political economy methods to approach public health policy and research.  

Dr. Lynch's argument is persuasive– that health in communities is a complex topic, and a political economy approach can help us unpack the big, macro-level structural determinants that constitute it. This distribution of the upstream and non-medical determinants of health can be better understood by analyzing the organization of those which constitute it: politics, society, and the economy.  

We should be conceptualizing politics, and thereby public health, as a product of interest-maximization, from the perspective of both those in government and policy positions as well as the community’s actions to reshape those institutions.  

Looking further, she provided some considerations into the models used in both fields to illustrate these structural determinants, such as the Dahlgren-Whitehead ‘rainbow model’. These models might not account for the ‘squishyness’ and nebulous character of what might constitute some public health outcomes, however, and instead posited that we should approach structural determinants as ‘clouds’.  

For example, clouds inherently in their nature are “extremely upstream”, and while they may seem solid from a distance, are aggregates made up of a host of smaller components and other ephemera.   

Watch a recording of the talk for more insights from Dr. Lynch: