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Critical Reflections on Knowledge Production In addition to structuring lived experiences, power relations structure the production of knowledge (Foucault et al. 2008; Morgan 1998). The third theme is a focus on critical reflections on science, including the questions we ask, the methods and analyses we employ, the results we reach, how research is funded, and how it impacts our lives. If the social contexts of science and research are left unquestioned, then our subjectivities and assumptions are left unexamined. Often this has led to interpretations of inequality as inevitable and natural. A critical biocultural approach recognizes the inherent political dimensions of all research, whether explicit or implicit (e.g., political ramifications of the “small but healthy hypothesis”). Taking a critical perspective on scientific knowledge production, rather than being anti-scientific, as it is often portrayed, is a step toward a more reflective science.

Human Agency A fourth theme is a greater attention to human agency in constructing environments and actively and creatively coping with problems and uncertainties. The goal here is a focus on the interplay between “structure and agency,” how social relations are constructed through human actions and simultaneously serve to structure those actions. Parallel arguments within evolutionary approaches highlight the role of organisms in constructing the very niches assumed to be the context of adaptive response. To say that one’s actions contribute to the social and environmental contexts of everyday lives in no way seeks to focus blame on lifestyle choices as the cause of their health problems. Rather, the idea is to understand how inequalities constrain agency and thus create contexts where the costs inherent in social and behavioral responses to stress are likely to be amplified. Human actions create spaces of vulnerability for some more than others, and individuals experience, perceive, and respond to conditions of vulnerability in different ways, shaped by their social and cultural position. It is always appropriate to ask “adaptive for whom” and in “what context”; who gains and who loses. As critical epidemiologist Nancy Krieger (2001, p. 674) comments, it is important to think “critically and systematically about intimate and integral connections between our social and biological existence – and, especially in the case of social production of disease and ecosocial theory, to name explicitly who benefits from and is accountable for social inequalities in health.”