Evidence-based public health (nursing) and the science of eliminating health inequalities in the era of globalization

At the dawn of the 21st century, there is a move towards ²evidence-based everything² and many public health nurses feel the hot breath of the evidence-based practice and policy movement on their neck. The rise of this evidence-based movement is a sociohistorically interesting process, raising important questions about professional and decision-making practices and their epistemological basis, and about the types of evidence that contribute to that evidence base. Many of these issues are particularly important in contemporary debates around health disparities. Our purpose is to refute a Manichean view of evidence-based public health nursing (EBPHN), and to delineate the influences of our globalized world and its transformative dynamic on knowledge translation in decision-making environments. Our reasoning is based on the results of a mixed methods research study conducted in Canada within the period 2005-2008. Drawing on a transdisciplinary perspective, we theorized how the emergence of contemporary globalization is complexly and intimately interrelated with a restructuring public health field, with the rise of the evidence-based movement and with the development of the new interdisciplinary knowledge translation (research) field. Changing patterns of healthcare services and policies, disease, and medicine have been integrally linked to the historical evolution of human societies. In this presentation, we highlight the relationships between the evidence-based movement as nomothetic enterprise, and the various logics and imaginations driving or embodied within the sociohistorical process of globalization. We suggest that EBPHN can accommodate different forms of knowledge and evidence. We finally propose a fruitful way of thinking dialectically EBPHN and approaching the complexity of EBPHN to tackle health inequalities.