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Studying health inequalitiesAn applied approach$
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Jonathan Wistow, Tim Blackman, David Byrne, and Gerald Wistow

Print publication date: 2015

Print ISBN-13: 9781447305286

Published to Policy Press Scholarship Online: May 2016

DOI: 10.1332/policypress/9781447305286.001.0001

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Health inequalities, wicked problems and complexity

Health inequalities, wicked problems and complexity

(p.21) Two Health inequalities, wicked problems and complexity
Studying health inequalities

Jonathan Wistow

Tim Blackman

David Byrne

Gerald Wistow

Policy Press

The chapter begins by considering what we mean by ‘health’ and by ‘inequalities’. When taken together health inequalities are often considered to be wicked problems – issues that are complex in terms of causal pathways, difficult to define and with no immediate solutions. They can pose challenges to traditional approaches to policy making and programme implementation. Furthermore, methodological approaches need to fit with the nature of the ‘problem’ i.e., responding to causal relationships in complex settings. Complexity theory provides one such approach. The chapter applies complexity theory to health inequalities by unpacking these concepts across the following dimensions: scales and boundaries; non-linear dynamics; self-organisation; and co-evolution. In so doing it is argued that we must avoid the temptation to control, isolate and reduce components of dynamic social systems to discrete elements and consider the interactions between histories, contexts and agency so as to be able to fully understand and respond to health inequalities.

Keywords:   health, inequality, wicked problems, scales and boundaries, non linear dynamics, self organisation, co evolution

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