The quest for equity in global health is underpinned by neocolonial discourses: A critical discourse analysis
Bibliographic record
Abstract
Global health, as noted in the emerging decolonizing global health literature, is built on power asymmetries and inequities, is centred on individuals and organizations in the global north, and involves a north to south diffusion of ideas and resources. Despite increasing attention paid to the decolonization of global health, there is no universal understanding of what this entails, or what associated agenda(s) may be. We argue that decolonizing global health is not possible without interrogating its many power asymmetries. In this article we demonstrate one example, using a critical discourse analysis of a tremendously influential document, the final report of the World Health Organization's Commission on Social Determinants of Health, Closing the gap in a generation: Health equity through action on the social determinants of health. This report brought mainstream attention to health inequities and the broader forces that underpin them. We reasoned that a flagship report focused on equity and the social determinants of health would be sensitive to the many power inequities in global health. Our critical discourse analysis reveals normative views that presume inequity, such as Euro-American-centricity and portraying countries of the global south as behind or inferior to those of the global north and requiring support. Also, we find that many country comparisons exclude rich countries, which hides the full extent of global inequity. By drawing attention to the inequities presumed in language, we illuminate the persistence of neocolonial ideas that accept rather than contest unfairness.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.037 | 0.023 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.007 | 0.005 |
| Science and technology studies | 0.020 | 0.093 |
| Scholarly communication | 0.022 | 0.022 |
| Open science | 0.003 | 0.011 |
| Research integrity | 0.006 | 0.008 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".