{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T13:23:05Z","timestamp":1784812985228,"version":"3.55.0"},"reference-count":88,"publisher":"American Public Health Association","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Public Health"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:p> The social determinants of health (SDOH) framework has proven useful for research and practice in addressing the social causes of many health outcomes. However, its limitations may restrict its value as the world undergoes rapid ecological and social change. <\/jats:p><jats:p> We argue that SDOH does not adequately incorporate rapidly changing or \u201cfar upstream\u201d social processes (particularly social movements), the dialectics of social conflict and creative social innovation, or bidirectional causation. <\/jats:p><jats:p> Ecosocial theory addresses some of these issues, yet dialectical frameworks offer additional insights during periods of rapid social change and disruption. The implications for research methods and practice are discussed. ( Am J Public Health. 2025;115(11):1868\u20131876. https:\/\/doi.org\/10.2105\/AJPH.2025.308239 ) <\/jats:p>","DOI":"10.2105\/ajph.2025.308239","type":"journal-article","created":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T20:08:47Z","timestamp":1758226127000},"page":"1868-1876","source":"Crossref","is-referenced-by-count":2,"title":["Dialectical Processes of Health Framework as an Alternative to Social Determinants of Health Framework"],"prefix":"10.2105","volume":"115","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2083-1226","authenticated-orcid":false,"given":"Samuel R.","family":"Friedman","sequence":"first","affiliation":[{"name":"Samuel R. Friedman, Suzan M. Walters, and Jerzy Eisenberg-Guyot are with the Center for Opioid Epidemiology and Policy and Department of Population Health, NYU Grossman School of Medicine, New York, NY. Ashly E. Jordan, David C. Perlman, and Pedro Mateu-Gelabert are with the Center for Drug Use and HIV\/HCV Research, New York, NY. Georgios K. Nikolopoulos is with the Medical School, University of Cyprus, Nicosia, Cyprus. Diana Rossi is a retired professor and researcher, and a founding member and consultant of Intercambios Civil Association, Buenos Aires, Argentina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzan M.","family":"Walters","sequence":"additional","affiliation":[{"name":"Samuel R. Friedman, Suzan M. Walters, and Jerzy Eisenberg-Guyot are with the Center for Opioid Epidemiology and Policy and Department of Population Health, NYU Grossman School of Medicine, New York, NY. Ashly E. Jordan, David C. Perlman, and Pedro Mateu-Gelabert are with the Center for Drug Use and HIV\/HCV Research, New York, NY. Georgios K. Nikolopoulos is with the Medical School, University of Cyprus, Nicosia, Cyprus. 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