Choosing a future for epidemiology: II. From black box to Chinese boxes and eco-epidemiology.

Susser, Mervyn; Süsser, Ezra

doi:10.2105/ajph.86.5.674

Cited by 698 publications

(413 citation statements)

References 10 publications

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“…If the relationship between built environment and health was linear as shown in Figure 1, then, as strong associations were observed between the built environment and destination walking, and between destination walking and health, it would seem to follow that there would be observable strong associations between built environment and health. 48 These last associations were not observed.…”

Section: Adverse Eventsmentioning

confidence: 89%

Complexity in Built Environment, Health, and Destination Walking: A Neighborhood-Scale Analysis

et al. 2012

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This study investigates the relationships between the built environment, the physical attributes of the neighborhood, and the residents' perceptions of those attributes. It focuses on destination walking and self-reported health, and does so at the neighborhood scale. The built environment, in particular sidewalks, road connectivity, and proximity of local destinations, correlates with destination walking, and similarly destination walking correlates with physical health. It was found, however, that the built environment and health metrics may not be simply, directly correlated but rather may be correlated through a series of feedback loops that may regulate risk in different ways in different contexts. In particular, evidence for a feedback loop between physical health and destination walking is observed, as well as separate feedback loops between destination walking and objective metrics of the built environment, and destination walking and perception of the built environment. These feedback loops affect the ability to observe how the built environment correlates with residents' physical health. Previous studies have investigated pieces of these associations, but are potentially missing the more complex relationships present. This study proposes a conceptual model describing complex feedback relationships between destination walking and public health, with the built environment expected to increase or decrease the strength of the feedback loop. Evidence supporting these feedback relationships is presented.

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Section: Adverse Eventsmentioning

confidence: 89%

Complexity in Built Environment, Health, and Destination Walking: A Neighborhood-Scale Analysis

et al. 2012

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“…In writing this article, we want to propose an alternative approach that does not lapse into extremes, but adopts a middle course that combines the advantages of different approaches in a flexible and context-sensitive whole. We argue that the best way for medicine to be in the future is not reductionist, nor holist, but 9 see also [26,[31][32][33][34] 10 see, e.g., Fee and Krieger [35] with respect to AIDS, Smith and Ruiz [36] with respect to Coronary Heart Disease, Vinetz et al [37] with respect to Leptospirosis, and Chaufan [29] with respect to Diabetes type 2. 11 S. Nassir Ghaemi, for example, nicely describes in his recent book how the methodologically holistic stance of the biopsychosocial model made the approach unfeasible in practice by being too general and too vague [38].…”

Section: Explanatory Pluralism and Actual Medical Research And Practicementioning

confidence: 99%

Explanatory pluralism in the medical sciences: Theory and practice

2010

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Abstract:Explanatory pluralism is the view that the best form and level of explanation depends on the kind of question one seeks to answer by the explanation, and that in order to answer all questions in the best way possible, we need more than one form and level of explanation. In the first part of this article, we argue that explanatory pluralism holds for the medical sciences, at least in theory. However, in the second part of the article we show that medical research and practice is actually not fully and truly explanatory pluralist yet. Although the literature demonstrates a slowly growing interest in non-reductive explanations in medicine, the dominant approach in medicine is still methodologically reductionist. This implies that non-reductive explanations often do not get the attention they deserve. We argue that the field of medicine could benefit greatly by reconsidering its reductive tendencies and becoming fully and truly explanatory pluralist. Nonetheless, trying to achieve the right balance in the search for and application of reductive and non-reductive explanations will in any case be a difficult exercise.

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“…Then, Krieger presented her critique of the web of causation model, 48 Pearce pointed to what had been lost in the change from traditional environment-oriented epidemiology to the person-oriented modern epidemiology, 49 and the Sussers presented their Chinese boxes model. 50 Multilevel analysis was well established in epidemiology by that time, but studies were centered on the effects of group-level characteristics on individual-level outcomes. 51 Krieger developed the concept of embodiment [52][53][54] for the interaction of person and society that is central to the epidemiologic theory.…”

Section: Multilevel Epidemiologymentioning

confidence: 99%

Corporation-induced Diseases, Upstream Epidemiologic Surveillance, and Urban Health

Jahiel

2008

J Urban Health

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Corporation-induced diseases are defined as diseases of consumers, workers, or community residents who have been exposed to disease agents contained in corporate products. To study the epidemiology and to guide expanded surveillance of these diseases, a new analytical framework is proposed. This framework is based on the agent-host-environment model and the upstream multilevel epidemiologic approach and posits an epidemiologic cascade starting with government-sanctioned corporate profit making and ending in a social cost, i.e., harm to population health. Each of the framework's levels addresses a specific level of analysis, including government, corporations, corporate conduits, the environment of the host, and the host. The explained variable at one level is also the explanatory variable at the next lower level. In this way, a causal chain can be followed along the epidemiologic cascade from the site of societal power down to the host. The framework thus describes the pathways by which corporate decisions filter down to disease production in the host and identifies opportunities for epidemiologic surveillance. Since the environment of city dwellers is strongly shaped by corporations that are far upstream and several levels away, the framework has relevance for the study of urban health. Corporations that influence the health of urban populations include developers and financial corporations that determine growth or decay of urban neighborhoods, as well as companies that use strategies based on neighborhood characteristics to sell products that harm consumer health. Epidemiological inquiry and surveillance are necessary at all levels to provide the knowledge needed for action to protect the health of the population. To achieve optimal inquiry and surveillance at the uppermost levels, epidemiologists will have to work with political scientists and other social scientists and to utilize novel sources of information.

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Choosing a future for epidemiology: II. From black box to Chinese boxes and eco-epidemiology.

Cited by 698 publications

References 10 publications

Complexity in Built Environment, Health, and Destination Walking: A Neighborhood-Scale Analysis

Complexity in Built Environment, Health, and Destination Walking: A Neighborhood-Scale Analysis

Explanatory pluralism in the medical sciences: Theory and practice

Corporation-induced Diseases, Upstream Epidemiologic Surveillance, and Urban Health

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