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Conceptualising population health: from mechanistic thinking to complexity science

机译:人口健康概念化:从机械思维到复杂性科学

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摘要

The mechanistic interpretation of reality can be traced to the influential work by René Descartes and Sir Isaac Newton. Their theories were able to accurately predict most physical phenomena relating to motion, optics and gravity. This paradigm had at least three principles and approaches: reductionism, linearity and hierarchy. These ideas appear to have influenced social scientists and the discourse on population health. In contrast, Complexity Science takes a more holistic view of systems. It views natural systems as being 'open', with fuzzy borders, constantly adapting to cope with pressures from the environment. These are called Complex Adaptive Systems (CAS). The sub-systems within it lack stable hierarchies, and the roles of agency keep changing. The interactions with the environment and among sub-systems are non-linear interactions and lead to self-organisation and emergent properties. Theoretical frameworks such as epi+demos+cracy and the ecosocial approach to health have implicitly used some of these concepts of interacting dynamic sub-systems. Using Complexity Science we can view population health outcomes as an emergent property of CAS, which has numerous dynamic non-linear interactions among its interconnected sub-systems or agents. In order to appreciate these sub-systems and determinants, one should acquire a basic knowledge of diverse disciplines and interact with experts from different disciplines. Strategies to improve health should be multi-pronged, and take into account the diversity of actors, determinants and contexts. The dynamic nature of the system requires that the interventions are constantly monitored to provide early feedback to a flexible system that takes quick corrections.
机译:对现实的机械解释可以追溯到RenéDescartes和Isaac Newton爵士的有影响的作品。他们的理论能够准确预测与运动,光学和重力有关的大多数物理现象。这种范式至少具有三个原理和方法:简化主义,线性和等级制度。这些想法似乎已经影响了社会科学家和有关人口健康的论述。相比之下,复杂性科学则更全面地看待系统。它认为自然系统是“开放的”,边界模糊,并不断适应环境压力。这些被称为复杂自适应系统(CAS)。它内部的子系统缺乏稳定的层次结构,代理商的角色不断变化。与环境以及子系统之间的交互是非线性交互,并导致自组织和紧急属性。诸如Epi + Demos + Cracy和健康的生态社会方法之类的理论框架隐含地使用了这些相互作用的动态子系统的概念。使用复杂性科学,我们可以将人口健康结果视为CAS的新兴属性,而CAS在其相互联系的子系统或代理之间具有众多动态非线性相互作用。为了欣赏这些子系统和决定因素,人们应该掌握各种学科的基础知识,并与不同学科的专家进行互动。改善健康的策略应多管齐下,并考虑到行为者,决定因素和环境的多样性。系统的动态性质要求对干预措施进行持续监控,以便为需要快速纠正的灵活系统提供早期反馈。

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