Journal supplement examines social dominance, ethics, and children’s health

March 31, 2015

children bullyingThe journal Pediatrics published a special supplement on bioethics co-edited by Dr. John Lantos of the University of Missouri-Kansas City School of Medicine and Dr. Jodi Halpern, professor of bioethics in the UC Berkeley-UCSF Joint Medical Program. The supplement, published March 2, 2015, looks beyond the long-term mental and physical health consequences of victimization from bullying and examines more broadly the relationship of bullying to social hierarchies and power differentials in society.

“This is a highly innovative focus for the respected journal Pediatrics, moving beyond typical individual-focused medical ethics approaches to reach to the social determinants of health and how they require an entirely novel ethical approach to protecting child health,” said Halpern.

Halpern is first author of an article, “Social Dominance, School Bullying, and Child Health: What Are Our Ethical Obligations to the Very Young?” The article considers the enduring health impact of subordination among young schoolchildren, as demonstrated by the work of Dr. Thomas Boyce, former director of the UC Berkeley-UCSF Joint Medical Program (JMP) and now at UCSF, and the ethical implications of these harmful effects. “Children’s rights to protection from social harms can be as strong as their rights to protection from direct bodily harms,” the authors conclude. Dr. Douglas Jutte, associate adjunct professor and associate director of the JMP masters degree program, is a coauthor, along with Boyce and Jacqueline Colby.

Jutte is also first author of another article in the supplemental issue, “Neighborhood Adversity, Child Health, and the Role for Community Development.” He and coauthors discuss the need for greater partnership between the nonprofit community development sector and public health to improve health outcomes for children in high-poverty neighborhoods. “Social inequality is the population equivalent of the social hierarchies that exist among school children on the playground,” they write. They call upon pediatricians to partner with those working at the community level to provide children with environments that optimize healthy early childhood development.

According to Halpern, “Bullying and social dominance involve the repeated abuse of power at a group level. Addressing this problem therefore requires a structural approach akin to that needed to address other social determinants of health disparities. We present a new argument showing why society has the very strongest moral obligation to address such structural issues, equivalent to the obligation each person has to refrain from deliberately harming someone else.”

By Michael S. Broder