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Appropriate Research Methods

4. What's Wrong

What’s Wrong With the Way We’re Doing Things?

No one can question the remarkable contribution of the social and behavioral sciences to understanding the causes and consequences of illness, disability and death.  From the early public health activities of 17th and 18th century Europe until today, the range of problems tackled, the exquisite methods developed, and the programs and policies attributable to specific findings has been remarkable.  While acknowledging remarkable progress, some question the current direction of the behavioral and social sciences and their underlying theoretical assumptions, or whether they actually have a theoretical base.  In marked contrast to the origins of behavioral and social science, research methods today appear hamstrung by the assumptions that follow from adherence to the individualist/natural science paradigm, and the types of activities suggested by its results.  Before moving in different directions it’s important to critically assess the current state of play. Here’s where things get a little controversial. Several key features of social and behavioral science are characterized here:

Established social and behavior science as applied to health is characterized by at least the following features:

  • Biophysiologic Reductionism
  • Absorption by Biomedicine
  • It is Largely Atheoretical
  • Limitations of Dichotomous Thinking
  • A Maze of Risk Factors
  • Observational Associations are Confused with Causality
  • Dogmatism by Design
  • More of the Same is Not the Answer

(a) Biophysiologic Reductionism. This involves a process by which phenomena, whether primarily physical or behavioral, are traced back to some bacteriological, genetic, or behavioral level of explanation such as lifestyle factors and risk behaviors. Even sociological phenomena – like socioeconomic, race/ethnic difference in diabetes mellitus – are often presumed to have biophysiologic or genetic origins. Plausible structural explanations in social deprivation and biases in treatment are overlooked in preference for identifying physiological and genetic factors and therefore biomedical interventions;

(b) Absorption by Biomedicine. Moving from their distinct philosophical origins and their status as independent disciplines, the behavioral and social sciences often appear to have become just an adjunct to clinical medicine.