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Interconnected
health-environmental challenges:
Between the implosion of the
modernist evidence regime and the
emergence of alternative evidence practices?
Guido Caniglia (he/him) and Federica Russo (she/her)
@GuidoCaniglia |@federicarusso
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
?
?
ALTERNATIVE
EVIDENCE
PRACTICES
4
?
?
5
?
?
Part 1
Modernist evidence regime
6
?
?
Part 1
Part 2
PARTICIPATORY
EVIDENCE
PRACTICES
Modernist evidence regime
7
?
?
Part 1
Part 3
ALTERNATIVE
EVIDENCE
PRACTICES
Part 2
Modernist evidence regime
PARTICIPATORY
EVIDENCE
PRACTICES
A different way of
conceptualizing
evidence?
Evidence Action
Evidence
Action
Actors
Modernist evidence regime
Participatory evidence practices
?
?
9
ALTERNATIVE
EVIDENCE
PRACTICES
Part 1
The ‘modernist evidence regimes’
10
Evidence-based medicine and policy:
The RCT paradigm
Eco-modernism and solutionism
in sustainability
The ‘modernist evidence regime’
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
12
?
?
Part 1
Part 2
Part 3
ALTERNATIVE
EVIDENCE
PRACTICES
13
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
14
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
15
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”
16
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. (Under review) How is Who: Evidence as clues for action in participatory
environmental health research
Evidence
Action
Actors
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
18
?
?
Part 1
Part 3
ALTERNATIVE
EVIDENCE
PRACTICES
19
?
?
What is happening?
Can these participatory alternative practices thrive? Can
they represent incipient regimes? Can there be
integration of the “modernist regime” and these practices?
What (do we think) should happen?
Is a new epistemology enough? What about the values
underpinning the science systems? And the institutions
supporting those values?
Interconnected
health-environmental challenges:
Between the implosion of the
modernist evidence regime and the
emergence of alternative evidence practices?
Guido Caniglia (he/him) and Federica Russo (she/her)
@GuidoCaniglia |@federicarusso
Thanks for your attention

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Interconnected health-environmental challenges, Health and the Environment: concepts, methods, and policy.

  • 1. Interconnected health-environmental challenges: Between the implosion of the modernist evidence regime and the emergence of alternative evidence practices? Guido Caniglia (he/him) and Federica Russo (she/her) @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?
  • 7. 7 ? ? Part 1 Part 3 ALTERNATIVE EVIDENCE PRACTICES Part 2 Modernist evidence regime PARTICIPATORY EVIDENCE PRACTICES A different way of conceptualizing evidence?
  • 8. Evidence Action Evidence Action Actors Modernist evidence regime Participatory evidence practices
  • 10. 10 Evidence-based medicine and policy: The RCT paradigm Eco-modernism and solutionism in sustainability The ‘modernist evidence regime’
  • 11. 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
  • 12. 12 ? ? Part 1 Part 2 Part 3 ALTERNATIVE EVIDENCE PRACTICES
  • 13. 13 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
  • 14. 14 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
  • 15. 15 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”
  • 16. 16 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. (Under review) How is Who: Evidence as clues for action in participatory environmental health research Evidence Action Actors
  • 17. 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
  • 19. 19 ? ? What is happening? Can these participatory alternative practices thrive? Can they represent incipient regimes? Can there be integration of the “modernist regime” and these practices? What (do we think) should happen? Is a new epistemology enough? What about the values underpinning the science systems? And the institutions supporting those values?
  • 20. Interconnected health-environmental challenges: Between the implosion of the modernist evidence regime and the emergence of alternative evidence practices? Guido Caniglia (he/him) and Federica Russo (she/her) @GuidoCaniglia |@federicarusso Thanks for your attention

Editor's Notes

  1. Thanks for the introduction. As mentioned this work has been developed with my dear friend Federica Russo. It is work-in progress. IT IS OUR ATTEMPT TO CAPTURE AND MAKE SENSE SOME DYNAMICS IN THE WAY HEALTH-ENVIRONMENTAL CHALLENGES ARE NOT ONLY INVESTIGATED BUT ALSO ADDRESSED. About two years ago in the middle of the pandemic we reconnected. Me 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.
  2. I will present WORK IN PROGRESS THAT WE HAVE BEEN DOING TOGETHER ON ISSUES INTERSECTING … HELATH AND ENVIRONMENTAL CONSIDERATIONS … 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? We 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 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 THE KNOWLEDGE SOCIETY AND ALTERNATIVE PRACTICES OF GENERATING EVIDENCE AND MAKING DECISIONS
  3. WE USED A way to visualise and communicate with each other about these things informed and inspired by the so-called 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 [28,36,37] 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 [22]. Landscape changes can generate opportunities for niches and/or represent a source of pressure for regime change [41]. Niches are spaces where innovative activity takes place and where protection is offered from dominant rules [27,41]. The
  4. Sometimes … these new practices make it to substitute … complement … influence the regime … generating radical change … TRANSITION …
  5. Part 1: MODERNIST EVIDENCE REGIME in the understanding of health-environmental
  6. Part 2: Pushed from bottom up (PARTICIPATORY experiments/projects/niches) BUT ALSO DERIVED FROM BROADER CHANGES, such as climate change or covid
  7. Part 3: try to elaborate on what we may do to further enhance the understanding of what is going on
  8. Modernist evidence regime
  9. ECO-MODERNISM: An example of an instantiation of the modernist evidence regime in the environmental sciences is represented by so-called Ecomodernism (CITE). Ecomodernists recognize the health impacts of climate and environmental change: “Much of the world’s population still suffers from more-immediate local environmental health risks. Indoor and outdoor air pollution continue to bring premature death and illness to millions annually. Water pollution and water-borne illness due to pollution and degradation of watersheds cause similar suffering” (Manifesto). 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 (Manifesto). Through intensification and technological development, human societies will be able to “use less land and interfere less with the natural world” (Manifesto). 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. climate change as GHG emissions and by focusing on blueprints to address such emissions and temperature reductions (Hulme). It is on identifying and acting on the most efficient and effective pathways to decarbonization that climate change may be addressed, such as through fuel efficiency standards or renewable energy tax credits (CITE). Thus the evidence and knowledge necessary to address climate change are generated through technological assessments used then to inform policies and interventions (CITE). EBM e’ un bell’esempio perche’ quando hanno cominciato a teorizzarla e praticarla, era un incipient regime. Andava contro un modo NON sistematico di valutare le evidenze mediche, ha introdotto profondi cambiamenti IN BENE in medicina — qui hai sicuramente elementi di cambiamento di paradigma kuhniano. MA dopo che ha generato cambiamento nel regime dominante, invece di diventare inclusivo e’ diventato ESCLUSIVO: solo RCT genera evidenza di sufficiente qualità’, solo RCT genera evidenza che porta a azione legittima. La logica di RCT e’ quell’episteme basata su controllo, linearità’, etc. Quindi il problema non e’ EBM, ma avere SOLO EBM. KEEPING THE SEPARATION
  10. 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
  11. Many names/ methodologies/ approaches
  12. MANY MANY EXAMPLES OF PARTICIPATORY APPROACHES, PROJECTS, PLATFORMS … INCLUDED THE CREATION OF NEW SPACES … SUCH AS REAL-WORLD LABS AND LIVING LABS …
  13. MANY MANY EXAMPLES OF PARTICIPATORY APPROACHES, PROJECTS, PLATFORMS … INCLUDED THE CREATION OF NEW SPACES … SUCH AS REAL-WORLD LABS AND LIVING LABS …
  14. Knowledge Evidence … what it not … but then what it is?
  15. To summarise and going back to the assumptions
  16. Part 3: can we detect a potential transition?
  17. Thanks for the introduction. As mentioned this work has been developed with my dear friend Federica Russo. It is work-in progress. IT IS OUR ATTEMPT TO CAPTURE AND MAKE SENSE SOME DYNAMICS IN THE WAY HEALTH-ENVIRONMENTAL CHALLENGES ARE NOT ONLY INVESTIGATED BUT ALSO ADDRESSED. About two years ago in the middle of the pandemic we reconnected. Me 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.