Cadernos de Saúde Pública
Print version ISSN 0102-311X
SCHRAMM, Fermin R. and CASTIEL, Luis David. Health/disease process and complexity in epidemiology. Cad. Saúde Pública [online]. 1992, vol.8, n.4, pp. 379-390. ISSN 0102-311X. http://dx.doi.org/10.1590/S0102-311X1992000400004.
The use of the idea of Complexity in Epidemiology is an approach to point out either an internal disciplinary crisis, resulting from shortcomings in its conceptual instruments (theories, models) regarding health's concrete reality, or a crisis in terms of the broader cultural context (paradigms, epistemic framework, Zeitgeist, Weltanschauung) in which health issues are necessarily inserted. Although those two approaches are pertinent from a systemic and environmental standpoint, their disjunction is insufficient in dealing with the main contemporary health challenges that affect individuals, populations and the biosphere. Complexity consists of a point of view that appears to overcome this obstacle. On the one hand, it stresses the reductionism of dichotomous visions that shaped the Modern Age, generally unable to focus on a living universe made up of relations and the emergence of new properties, when we move from one level of organization to another. On the other hand, ways of dealing with living beings' interactive processes are presented. A dynamic, historical and evolutive perspective is presented as a way of looking upon the crisis in Epidemiology as a sign, pointing out the need to conceive a complex approach towards its practical discursive instruments in order to devise more suitable patterns for the Health/Disease process.
Keywords : Epidemiology; Epistemology; Complexity.