Interconnected health-environmental challenges: Between the implosion of the modernist evidence regime and the emergence of alternative evidence practices
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Interconnected health-environmental challenges: Between the implosion of the modernist evidence regime and the emergence of alternative evidence practices
- 1. Interconnected health-environmental challenges: Between the implosion of the modernist evidence regime and the emergence of alternative evidence practices Guido Caniglia and Federica Russo @GuidoCaniglia |@federicarusso
- 2. 2 Interconnected health-environmental challenges Wicked problems Why are we failing? Can we attribute failures to “existing evidence regimes”? Are there alternatives? Do these alternatives question, threaten the“failing” existing regimes? Can we detect a potential transition?
- 3. • Revisiting concept of evidence in partecipatory research • Inspired by Haack’s ‘evidence as clues’ • Allows to include HOW and WHO, and so to see interconnection of knowledge and action
- 4. Understanding and evaluating evidence regimes • Our argument has two steps: • Historical-epistemological • Understanding what is going in with these incipient forms of research • Epistemological-normative • Some approaches are programmatic, and we strive to return an understand of what a new regime should look like • Ultimately, we support a radical form of methodological and epistemological pluralism
- 5. What is a regime? • [Gadebusch-Bondio] Assumptions and procedures • To distinguish what counts as evidence and what does not • To determine how appropriate evidence should be generated or not • A combination of worldviews and practices, similar to notions of • [Kuhn] scientific paradigms • [Fleck] thought collectives • [Foucault] episteme • We aim to capture underlying assumptions and values • shaping how knowledge and evidence are produced, organised, transmitted, used/applied • within a particular historical period and as situated in specific socio-cultural-geographical contexts with their power relationships and structures
- 6. Borrowing terminology from transition studies in sustainability
- 8. 8 ? ?
- 9. Using transition studies to understand evidence regumes
- 10. 10 ? ? Part 1 Modernist evidence regime
- 11. 11 ? ? Part 1 Part 2 PARTICIPATORY EVIDENCE PRACTICES Modernist evidence regime
- 12. 12 ? ? Part 1 Part 3 ALTERNATIVE EVIDENCE PRACTICES Part 2 Modernist evidence regime PARTICIPATORY EVIDENCE PRACTICES A different way of conceptualizing evidence?
- 13. Evidence Action Evidence Action Actors Modernist evidence regime Participatory evidence practices
- 14. ? ? 14 ALTERNATIVE EVIDENCE PRACTICES Part 1 The ‘modernist evidence regimes’
- 15. 15 Evidence-based medicine and policy: The RCT paradigm Eco-modernism and solutionism in sustainability The ‘modernist evidence regime’
- 16. Modernist evidence regime Epistemological assumptions Certainty and predictability Knowledge first, then action Linear connection: best knowledge leads to best action Metaphysical assumptions Controllability (deterministic causal processes) We can control courses of action and their consequences Axiological assumptions Neutrality and objectivity Knowledge does not carry values, but actions do Evidence Action
- 17. 17 ? ? Part 1 Part 2 Part 3 ALTERNATIVE EVIDENCE PRACTICES
- 18. 18 Participatory research on environmental and health challenges (Some examples: Community-based participatory research; Community-engaged research; Adaptive co-management; Transition management; Extreme citizen science ; Real-world experiments; Participatory action research; Street science) “ …. researchers and communities are involved in all aspects of a research study” Democratisation, increased use of results, utility, relevance, transparency Connection with social, environmental, health justice issues and movements
- 19. 19 Participatory research on environmental and health challenges •Air quality monitoring •Urban blight •Exposure to environmental hazards (e.g., waste, pollution) •Promote healthy living •Design/evaluation of nature-based solutions in cities
- 20. 20 Participatory research on environmental and health challenges •Air quality monitoring •Urban blight •Exposure to environmental hazards (e.g., waste, pollution) •Promote healthy living •Design/evaluation of nature-based solutions in cities 2020-2030 “Promote research on transformational change to address the intertwined environmental, social and health issues and reach critical global goals towards sustainability and equity … by increasing participatory co-creation opportunities and capabilities”
- 21. 21 Participatory research on environmental and health challenges Knowledge: … embedded in personal, interpersonal and social contexts … not separate from action, but tightly entangled with deliberation and action Evidence: … not a place holder in the probabilistic relation of hypotheses, theories, data … not that generated by the ‘top methods’ of evidence hierarchies Caniglia G. & Russo F. (2024) How is Who: Evidence as clues for action in participatory environmental health research, HPLS Evidence Action Actors
- 22. Evidence Action Actors Evidence Action Modernist evidence regime Participatory evidence practices Epistemological assumptions Certainty/predictability Uncertainty /unpredictability Knowledge first, then action Knowledge and action interconnected Metaphysical assumptions Controllability/determinism) Complex causality/emergence We can control actions and their consequences. We can navigate but not stir emergent change processes Axiological assumptions Neutrality / objectivity Situated / embedded Knowledge does not carry values, but actions do Knowledge and actions carry values and normativity
- 23. 23 ? ? Part 1 Part 3 ALTERNATIVE EVIDENCE PRACTICES Are we transitioning to a new regime??
- 24. 24 What is happening? Can these participatory alternative practices thrive? Can they become a new regime? Can there be integration of the “modernist regime” and these practices?
- 25. An argument for radical pluralism • There is evidence that incipient approaches will be more than just incipient • They should not become a new mainstream regime • A new regime should be maximally pluralist • Epistemology, methodology, ethics of pluralism • Pluralism is not anything goes, but invitation to reason and discuss choices at all levels. • Pluralism is the way to foster dialogue, collegiality, inclusion
- 26. Interconnected health-environmental challenges: Between the implosion of the modernist evidence regime and the emergence of alternative evidence practices Guido Caniglia and Federica Russo @GuidoCaniglia |@federicarusso Thanks for your attention Part of this presentation has been done using Powerpoint Designer
Editor's Notes
- Thanks for the invitation. Pleased to be back. Pleased to have opportunity to present this work to this audience. Guido and I: in the middle of the pandemic we reconnected. Guido coming from philosophy and then sustainability and federica working on issues related to public health etc. And it is not a chance that we converged during those times. Work in progress, we have a draft, but still rough paper. Also based on previous paper that got published (long in the pipeline). IT IS OUR ATTEMPT TO CAPTURE AND MAKE SENSE of emerging methodological approaches to address HEALTH-ENVIRONMENTAL CHALLENGES.
- WE HAD THE IMPRESSION THAT THERE IS SOMETHING GOING ON IN BOTH FIELDS AND AT THEIR INTERSECTION THAT WAS QUESTIONING MAINSTREAM APPROACHES TO THE UNDERSTANDING OF EVIDENCE GENERATION AND USE. What is happening here when we think about the way knowledge is generated to understand and address these challenges? What are these failures telling us about how scientific knowledge and related evidence are generated and validated? Are there alternatives and how can we better understand those alternatives?
- AND WE STARTED TRYING TO MAKE SENSE OF THESE QUESTIONS LOOKING AT REGIME PRACTICES … BY ENGAGING WITH THE WORK THAT HAS BEEN DONE ON EVIDENCE IN fields such as sustainability and public health AND ALTERNATIVE PRACTICES OF GENERATING EVIDENCE AND MAKING DECISIONS = PARTICIPATORY First step: look at notion of evidence and notice that any existing approach was in a sense limited, not able to account for generation and use of ‘evidence’ in participatory practices We then started hypothesising whether or not there might be a TRANSITION going on … where mainstream evidence regimes are being questions and alternative to these regimes are emerging in multiple, chaotic, unplanned but also interconnected ways >> this is how the present work comes into play
- We use the Multi Level Perspective model …used in sustainability transition studies … Arie Rip and René Kemp … Frank Geels and Johan Schot Using different levels (Multilevel’ Y AXIS) and how they change over time (X AXIS) Regime includes the network of actors and social groups, the rules (formal and informal) they maintain to run the dominant system … encompass technologies, institutions and actors: Purpose (cf. societal function such as food), coherence, stability, non-guidance and autonomy. Regimes rarely undergo transformation or reconfiguration, and tend to change only incrementally. Landscape cannot be changed easily in the short run and includes exogenous events and trends such as demographic changes, macro-economic trends, political developments, wars and crises, deep cultural and societal values, and climate change. Landscape changes can generate opportunities for niches and/or represent a source of pressure for regime change. Niches are spaces where innovative activity takes place and where protection is offered from dominant rules.
- Sometimes … these new practices make it to substitute … complement … influence the regime … generating radical change … TRANSITION …
- Part 1: MODERNIST EVIDENCE REGIME in the understanding of health / environmental Interestingly, in modernist regimes health / environments are much separated. Different disciplines and empirical studies study them as separate
- Part 2: Pushed from bottom up (PARTICIPATORY experiments/projects/niches) BUT ALSO DERIVED FROM BROADER CHANGES, such as climate change or covid Two things can be observed: the change in methodological approach *and* in addressing them together, rather than separately
- Part 3: try to elaborate on what we may do to further enhance the understanding of what is going on
- At glance what we think is going on: Moderninst >> separation of evidence and action. First work work out best evidence, then best action should follow Partecipatory >> 1) actors are also in the picture, 2) there is intersection of actors, evidence generation, action
- Modernist evidence regime
- EBM nice example because When it started, it was itself an incipient regime, going against mainstream Went against a NON systematic way of evaluating medical evidence. Introduced lots of GOOD changes. [somehow a khunian paradigm shift] BUT then, became a dominant, mainstream, taking the features of an episteme, in Foucault’s sense, and of also of a thought collective Become an exclusve regime. Only RCT generate evidence of sufficient quality’,only RCT generates evidence that can licese action. Logic of RCT is an episteme based on control, linearity, … Issue with EBM is not EBM, but having EMB only ECO-MODERNISM >> ENV SCIENCE. IDEA OF TECHNO-FIX Ecomodernists recognize the health impacts of climate and environmental change The approach to address these challenges is sought for in the need to intensify human activities (such as farming, energy extraction, forestry, and settlement) as well as in developing technologies that would allow for decoupling human development from environmental impacts. Through intensification and technological development, human societies will be able to “use less land and interfere less with the natural world”. increasing investments in economic measures and technologies. It is especially by relying on new technologies that both economic modernization and environmental protection may be achieved, such as in order to mitigate climate change, to spare nature, and to alleviate global poverty. Such technologies allow for using natural ecosystem flows and services more efficiently allowing for reducing human impacts on the biosphere: “To embrace these technologies is to find paths to a good Anthropocene.” (Manifesto) technocratic understanding of the way decisions and actions, both economics and technological ones, may contribute to addressing these challenges. The evidence and knowledge necessary to address climate change are generated through technological assessments used then to inform policies and interventions (CITE). KEEPING THE SEPARATION
- Part 2: Landscape changes: POLYCRISES … CLIMATE CHANGE … FORCED AND UNMANAGEABLE MIGRATIONS … ENDOGENOUS CHANGES … THE LITTEL ARROWS: NEW EVIDENCE PRACTICES TO ADDRESS COMPLEX HEALTH-ENVIRONMENTAL CHALLENGES … THEY ARE BASED ON PARTICIPATORY DYNAMICS AND TRANSDISCIPLINARY METHODOLOGIES
- Many names/ methodologies/ approaches
- MANY MANY EXAMPLES OF PARTICIPATORY APPROACHES, PROJECTS, PLATFORMS … INCLUDED THE CREATION OF NEW SPACES … SUCH AS REAL-WORLD LABS AND LIVING LABS …
- MANY MANY EXAMPLES OF PARTICIPATORY APPROACHES, PROJECTS, PLATFORMS … INCLUDED THE CREATION OF NEW SPACES … SUCH AS REAL-WORLD LABS AND LIVING LABS …
- Knowledge Evidence … what it not … but then what it is?
- To summarise and going back to the assumptions
- Part 3: can we detect a potential transition? This is where our analusys shifts from being historico-epistemological to epistemological-normative We thought a lot about it, and we are leaning towards a pretty clear normative stance, that I explain next
- I have myself contributed to give arguments for pluralism About evidence (with EBM+ colleagues) About causality (the causal mosaic approach with Phyllis) More recently putting these two together in the context of techno-scientific practices. The work ahead is in further developing epistemological/methodological pluralism with questions about ethics. Why would pluralist regime lead to more justice (health, social), more sustainability, more attention to vulnerable groups, more respect for indigenous cultures