Pauline Flora Paulik
Johannes Kepler University Linz
Within epidemiology and public health, physical and mental health inequalities, i.e., differences in health status, outcomes, and opportunities, are most commonly explained through the social determinants of health. These have been powerful in identifying how social, economic, and political conditions shape health across the lifespan. Despite their explanatory power, SDoH frameworks address epistemic conditions and the role of knowledge for good health only indirectly through ‘educational attainment’ and ‘health literacy’. These indicators focus on the distribution and uptake of existing knowledge. Gaps, biases, and omissions embedded within what knowledge is produced in the first place, remain largely unexamined as potential drivers of health inequalities and sources of explanation. I aim to expand the scope of SDoH frameworks by asking: What if part of the problem of health inequalities is not just a lack of knowledge, but the systematic production of ignorance? I develop this argument through the case of men’s mental health, focusing on depression. Empirical research shows that cisgender men are less likely to seek help, more likely to delay treatment, and more likely to die by suicide compared to women. This is predominantly explained by masculinity ideals and low health literacy. Drawing on epistemologies of ignorance (Tuana 2006, Alcoff 2007, Mills 2007), I show how ignorance operates structurally across several sites within the domain of men’s mental health, including the recognition and interpretation of depressive symptoms. In these contexts, ignorance is an active feature of the epistemic context that serves a stabilizing social function. Attending to these dynamics helps explain why existing diagnostic frameworks may fail to capture men’s experiences, why interpretive resources remain limited, and why interventions are often delayed or ineffective, giving rise to adverse outcomes.
Chair: tba
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SOPhiA 2026 