Author: Jaime Breilh & Nancy Kreiger

Year: 2021

Rating: Informative 4/5 | Entertaining 5/5 | Inspiring 5/5

The book is split into three chapters. The first provides a rich historical account of the Latin American Social Medicine/Collective Health movement. The second critiques the linear, reductionist reasoning that dominates mainstream epidemiology, explaining why we need critical epidemiology in a world where planetary health is increasingly threatened due to the “exponential growth of a discriminatory, rapacious, and oligopolistic market economy” where “extreme unfairness is the characterising societal trait of our times”. The final chapter describes a transformative, transdisciplinary, and intercultural method of epidemiology that uplifts the strengths of critical thinking, indigenous knowledge, and community participation. 

The book does a good job at introducing big ideas and pushing for a paradigm shift in the way we conceptualise health, practise epidemiology, and consider solutions to global public health challenges. The theory-heavy text is brought to life through an illustrated example of the social determination of dengue in an agro-industrial region in Ecuador, along with discussions on how critical epidemiology could improve research on climate change and COVID-19. However, the language is at times difficult to digest with lots of philosophy-of-science jargon. I found some concepts hard to grasp—I got to the end feeling like I needed a second read through. That said, if you’re after a new way of thinking about the societal determination of disease with a scathing critique of colonialism, extractive capitalism, neoliberalism, and the “racist, patriarchal, and aristocratic philosophies” rooted in the foundations of mainstream science, then this might just be the book for you. 

Latin American scholars have been undertaking this emancipatory work for decades, publishing predominantly in Spanish and Portuguese, and it is a privilege that their ideas are now readily accessible to an English-speaking audience—a global health perspective we certainly have a lot to learn from.