In 2007, the periodical, Social Science & Medicine (one of the leading journals in community health science) published a special edition on the complexities of studying community health--65, Nov 2007, starting page 1281.
The theme of the special edition was PLACING HEALTH IN CONTEXT. As the editors of this edition, James Dunn and Steve Cummins state, "While there is a long history of interest in place and health in the geography of health, in the past decade or more a number of disciplines have witnessed an increasing interest in the ‘effect’ that attributes of collective social organization and the local built environment at neighbourhood scale have on a variety of social outcomes, including health, health behaviours, early child development, youth delinquency, crime and deviance, political behaviour, employment outcomes and other economic opportunities" (p. 1821).
While Dunn and Cummins agree that significant advances resulted from the research surrounding the community-as-context model (see earlier post), there is much still to be done. Put simply by me (and I do mean simply), the community-as-context model needs to be replaced by the community-as-complex-system model. That is not quite what they say, but it works for a general sense of the articles. The community-as-context needs to get sophisticated; as it stands currently, it lacks the theoretical and methodological rigor to get the job done.
As data for my statement, here, for example, is a quote from Dunn and Cummins toward the end of their editorial overview: "The collection of papers presented here that sow the seeds of debate, for example, on the role of neighbourhood preference in understanding associations between context and health, is a potential lightning rod. Similarly, the use of complexity theory, given its novelty and its dissimilarity to the conventional ‘black box’ approach of investigating the effects of interventions should also spark responses in the literature. All of the papers in this Special Issue point us in compelling new directions for research that places health in context. We hope that this special issue sparks debate and new lines of inquiry and look forward to its future repercussions" (p. 1821).
The list of authors that Dunn and Cummins draw upon is impressive. The arguements made by these authors is even more incredible. Agree with them or not, you need to read this special edition and consider the arguments its authors make!