Kline Nolan
Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX, 76107, USA; Department of Anthropology, Rollins College, 1000 Holt Ave, Winter Park, FL, 32789, USA.
Soc Sci Med. 2022 May;300:114498. doi: 10.1016/j.socscimed.2021.114498. Epub 2021 Oct 26.
The complexity of health systems and their social, political, and economic contexts has resulted in a call for multidisciplinary research that can appropriately examine the relationships and interactions surrounding health systems. Anthropologists, who have a disciplinary training that emphasizes social structures and human relationships, are well-suited to conduct health systems research. However, there remains a gap in anthropologically-ground methodological approaches for conducting in-depth, qualitative research that simultaneously conceptualizes and maps out a health system and examines connections between health systems and other social structures, such as immigration enforcement systems. Without such methodological approaches, limitations in examining a health system and its constituent elements will persist, and health and social scientists will miss opportunities to identify links between different factors in a health system and outside the system itself. In this article, I use ethnographic research examining the health-related consequences of immigration enforcement laws and police practices in the United States to show how to examine relationships between multiple social systems. In doing so, I provide an example for how to conduct in-depth, qualitative health systems research by merging theoretical frameworks in health sciences and anthropology to demonstrate how medical anthropologists can conceptualize a health system as a social field for ethnographic inquiry. Overall, I argue that such an approach permits anthropologists a way to conduct rigorous health systems research that emphasizes relationships and reveals potentially hidden interactions.
卫生系统的复杂性及其社会、政治和经济背景，引发了对多学科研究的需求，这种研究能够恰当地审视围绕卫生系统的各种关系和互动。人类学家接受过强调社会结构和人际关系的学科训练，非常适合开展卫生系统研究。然而，在进行深入的定性研究时，以人类学为基础的方法论仍存在差距，这种研究既要同时对卫生系统进行概念化和绘制图谱，又要考察卫生系统与其他社会结构（如移民执法系统）之间的联系。没有这样的方法论，在审视卫生系统及其组成要素时的局限性将持续存在，卫生和社会科学家将错失识别卫生系统内部不同因素与系统本身之外其他因素之间联系的机会。在本文中，我运用人种志研究来考察美国移民执法法律和警察做法对健康的影响，以展示如何研究多个社会系统之间的关系。在此过程中，我提供了一个示例，说明如何通过融合健康科学和人类学的理论框架来进行深入的定性卫生系统研究，以证明医学人类学家如何将卫生系统概念化为一个用于人种志探究的社会领域。总体而言，我认为这种方法使人类学家能够开展严谨的卫生系统研究，这种研究强调关系并揭示潜在的隐藏互动。
