CH 03: Researching Health: Methodological Traditions and Innovations

What do Marxist/political economy scholars focus on in health research?

Macro issues—historical/comparative data, structure of inequality, and its impact on health and health-care systems.

What do symbolic interactionist scholars study in health research?

Micro issues—people’s experiences of illness and the meanings they attach to those experiences.

How do feminist sociologists approach health research?

They address both macro and micro issues, centering women’s experiences, women’s health, and empowerment.

What are the main categories of research methods in health sociology?

Quantitative, qualitative, and mixed methods.

How has biomedical research shaped health sociology?

Its dominance defines “scientific” research, influences health-policy debates, and privileges methods like RCTs.

What do positivist methodologies claim to do?

Study the world through standardized, “objective,” value-free procedures, uninfluenced by politics, subjectivity, or culture.

What are quantitative/positivist methods best suited for?

Testing efficacy of treatments and identifying disease risk factors (e.g., RCTs, epidemiology).

What are their limitations in health sociology?

They fail to examine meanings, interpretations, and lived experiences of illness.

How are positivist methods valued by governments/funders compared to qualitative ones?

They are privileged, seen as more “scientific,” leading to under-research of cultural and interpretive dimensions of health.

Why are RCTs (Randomized Control Trials) considered the “gold standard” in clinical evidence?

They use random assignment, control groups, and comparisons to test treatment efficacy, reducing bias.

What criticism did Richards (1988) raise about RCTs?

They are political/socially influenced; rival clinics designed flawed trials (e.g., vitamin C and cancer) and suppressed alternative findings.

Where and when did EBM (Evidence Based Medicine) originate?

Early 1990s, McMaster University, Hamilton, Ontario.

What does EBM promote?

Clinical practice should be based on evidence from RCTs, privileging positivist data over other forms.

What are major criticisms of EBM?

• Narrow definition of evidence (ignores social/cultural determinants).

• One-size-fits-all model (ignores sex, class, ethnicity differences).

• Aligns with neoliberal rationalization of health care.

• Risks exporting Eurocentric interventions globally.

• Devalues interpretive/qualitative research.

How does EBM contribute to “somatic fundamentalism”?

Treats health as bodily parts to be “fixed,” ignoring holistic social/psychological dimensions (e.g., ADHD treated with drugs over social causes).

What is the traditional goal of epidemiology?

Identify disease distribution and risk factors for prevention/treatment.

Example: Who is considered the “father of epidemiology”?

John Snow—mapped London cholera cases to contaminated water supplies.

What is social epidemiology’s focus?

Inequalities in health at the societal level; relationships between health and social determinants (race, gender, class, Indigenous status, policy).

How has social epidemiology influenced HIV/AIDS prevention in Canada?

Showed higher risk among men who have sex with men, injection drug users, prisoners, and Indigenous communities, leading to targeted prevention.

What are the “fundamental causes” of health inequalities, according to Krieger (2001)?

Economic and political institutions and decisions that create/enforce social privilege and inequality.

What is ecosocial theory’s key concept?

Embodiment—how individuals biologically incorporate material and social environments over time.

Why is intersectionality important in health research?

Health outcomes aren’t just the sum of race + class + gender; intersections produce unique impacts (e.g., Aboriginal women’s experiences differ from non-Aboriginal women’s).

What is the main limitation of survey-based quantitative methods?

They can show correlations but not social mechanisms behind them.

How do qualitative methods complement quantitative ones in epidemiology?

They uncover meanings, mechanisms (e.g., racism, colonization), and “why”/“how” explanations missed by statistics.

How does the logic and practice of qualitative research differ from quantitative research?

Qualitative research emphasizes context, meanings, and interpretations, while quantitative research emphasizes statistics, measurement, and generalization.

What are the main strengths of qualitative research?

Its ability to contextualize situations, uncover meanings, and explore interpretations inaccessible to statistical methods.

What are the main weaknesses of qualitative research in the academic world?

It is often undervalued because positivist methods dominate policy-making, funding, and publishing.

How do sampling strategies differ between qualitative and quantitative research?

Quantitative uses random sampling for generalization; qualitative uses purposive sampling to capture diversity and ensure specific experiences are represented.

What is the purpose of purposive sampling?

To describe the processes, meanings, and interpretations behind people’s experiences, not to generalize statistically.

What does qualitative research emphasize about illness and health experiences?

That meanings are shaped by cultural and social contexts.

Why do qualitative researchers avoid terms like validity and reliability?

Because they imply fixed truths; instead, qualitative research emphasizes rigour, meaning careful scrutiny of changing meanings and interpretations.

How is qualitative data analysis different from quantitative?

It relies on interpretation rather than prescribed formulas; software like NVivo can assist but not automate analysis.

What is grounded theory?

An inductive method where data collection and analysis happen iteratively (“zig-zagging”) to build theory from participants’ experiences.

How do qualitative researchers treat subjectivity?

They acknowledge it openly, co-construct narratives with participants, and make their own values explicit.

Why is interview data considered co-created?

Because participants shape stories depending on context, meaning interviews are not static objective accounts.

What is Participatory Action Research (PAR)?

Collaborative research where participants are co-researchers, aiming for empowerment, social change, and health equity.

Example: How has PAR been used in Indigenous research?

By blending Indigenous methodologies with PAR to transform Indigenous peoples from research objects into authors of inquiry.

What is intersectionality in health research?

A paradigm that studies how overlapping identities (race, gender, class, sexuality, etc.) interact to shape health and illness.

What is Critical Race Theory’s (CRT) role in health research?

It centers race and racism as determinants of health disparities and pushes public health toward equity.

What is Public Health Critical Race praxis (PHCR)?

A framework guiding researchers to apply CRT in public health research to conceptualize, measure, and address racism’s health effects.

What is autoethnography?

A qualitative method where researchers use personal experience reflexively to explore cultural and social phenomena.