Table Of ContentSpringerBriefs in Public Health
Forfurthervolume:
http://www.springer.com/series/10138
Brian Castellani • Rajeev Rajaram (cid:129) J. Galen
Buckwalter (cid:129) Michael Ball (cid:129) Frederic Hafferty
Place and Health as Complex
Systems
A Case Study and Empirical Test
2123
BrianCastellani MichaelBall
KentStateUniversity KentStateUniversity
Ashtabula,Ohio Ashtabula,Ohio
USA USA
RajeevRajaram FredericHafferty
KentStateUniversity PrograminProfessionalismandEthics
Ashtabula,Ohio MayoClinic
USA Rochester,Minnesota
USA
J.GalenBuckwalter
InstituteforCreativeTechnologies
UniversityofSouthernCalifornia
PlayaVista,California
USA
ISSN2192-3698 ISSN2192-3701(electronic)
SpringerBriefsinPublicHealth
ISBN978-3-319-09733-6 ISBN978-3-319-09734-3(eBook)
DOI10.1007/978-3-319-09734-3
LibraryofCongressControlNumber:2014960229
SpringerChamHeidelbergNewYorkDordrechtLondon
© SpringerInternationalPublishingSwitzerland2015
Thisworkissubjecttocopyright.AllrightsarereservedbythePublisher,whetherthewholeorpartofthe
materialisconcerned,specificallytherightsoftranslation,reprinting,reuseofillustrations,recitation,
broadcasting,reproductiononmicrofilmsorinanyotherphysicalway,andtransmissionorinformation
storageandretrieval,electronicadaptation,computersoftware,orbysimilarordissimilarmethodology
nowknownorhereafterdeveloped.
Theuseofgeneraldescriptivenames,registerednames,trademarks,servicemarks,etc.inthispublication
doesnotimply,evenintheabsenceofaspecificstatement,thatsuchnamesareexemptfromtherelevant
protectivelawsandregulationsandthereforefreeforgeneraluse.
Thepublisher,theauthorsandtheeditorsaresafetoassumethattheadviceandinformationinthisbook
arebelievedtobetrueandaccurateatthedateofpublication.Neitherthepublishernortheauthorsorthe
editorsgiveawarranty,expressorimplied,withrespecttothematerialcontainedhereinorforanyerrors
oromissionsthatmayhavebeenmade.
Printedonacid-freepaper
SpringerispartofSpringerScience+BusinessMedia(www.springer.com)
About the Authors
Brian Castellani, PhD is professor of sociology and head of the Complexity in
Health Group, Kent State University. He is also adjunct professor of psychia-
try, Northeastern Ohio Medical University and advisory board member, Center
for Complex Systems Studies, Kalamazoo College. Dr. Castellani is interna-
tionally recognized for his expertise in computational and complexity science
method and their application to several key topics in health and health care,
including community and public health. He is specifically recognized for his de-
velopment (with Dr. Rajaram) of a new approach to modeling, called case-based
complexity. And, he is known for developing the SACS Toolkit: a case-based,
mixed-methods platform for modeling the temporal and spatial dynamics of com-
plex systems, particularly in large and big data. For more on Castellani, see
(http://www.ashtabula.kent.edu/about/facultystaff/faculty/∼bcastel3/).
RajeevRajaram,PhDisassociateprofessorofmathematicsandresearchmember
of the Complexity in Health Group, Kent State University. As a mathematician,
Dr.Rajaramisinternationallyrecognizedforhisapplicationsofstabilityandcontrol
theoryofdifferentialequationstomodelingavarietyoftopics,includingcommunity
andpublichealth. Heisalsorecognized, withCastellani, forhisdevelopmentofa
case-basedcomplexityapproachandtheSACSToolkit. FormoreonRajaram, see
(http://www.kent.edu/math/profile/rajeev-rajaram).
J. Galen Buckwalter, Ph.D. is research scientist, Institute of Creative Tech-
nologies, University of Southern California and founding scientist, TidePool
(http://www.tidepool.co/).Dr.Buckwalterhashadanextremelyactivecareerbothas
anacademicresearchscientistandasanentrepreneurintheprivatesector.Hisaca-
demiccareer, withover100peerreviewedpublications, hasfocusedonadvancing
the field of psychometrics and personality testing/assessment, and, more recently,
resilienceandallostaticload.
Michael Ball, MS is research coordinator, Complexity in Health Group, Kent
State University. Mr. Ball is gaining an international reputation for multi-agent
modeling and machine intelligence, primarily in application to disease transmis-
sionandcommunityandpublichealth.FormoreonBall,visit(http://www.personal.
kent.edu/∼mdball/).
v
vi AbouttheAuthors
Frederic Hafferty, PhD is professor of medical education and professionalism,
Mayo Clinic. Dr. Hafferty is world-renown for his work in medical profession-
alism, the sociology of professions and medical education. He is specifically
known for his ground-breaking work in the hidden curriculum and its applica-
tion to medical education, as well as his development (with Castellani) of a
complex systems view of medical professionalism. For more on Hafferty, see
(http://www.researchgate.net/profile/Frederic_Hafferty).
Preface
Overthelastdecade,scholarshavedevelopedacomplexitiesofplace(COP)approach
tothestudyofplaceandhealth.AccordingtoCOP,theproblemwithconventional
public health research is that it lacks effective theories and methods to model the
complexitiesofneighborhoods,communitiesandsoforth,giventhatplacesexhibit
nineessential“complexsystem”characteristics:theyare(1)causallycomplex,(2)
self-organizingandemergent,(3)nodeswithinalargernetwork,(4)socio-spatially
dynamicandevolving, (5)nonlinear, (6)historical, (7)socio-spatiallyopen-ended
withfuzzyboundaries,(8)criticallyconflictedandnegotiated,and(9)agent-based.
However, whilepromising, theCOPapproachiscurrentlyfacedwithtwochal-
lenges:itscomprehensivedefinitionofcomplexityremainssystematicallyuntested;
anditsrecommendedcomputationalandcomplexitysciencemethods(e.g.,geospa-
tial modeling, social network analysis, agent-based modeling) have yet to be
organizedintoacohesiveframework.
ThecurrentstudythereforeconductedanexhaustivetestofallnineCOPcharacter-
isticsandsuggestedmethods.Toconductourtestwemadetwoimportantadvances:
First,wedevelopedandappliedtheDefinitionalTestofComplexSystems(DTCS)toa
casestudyoncommunityhealthandsprawl(acomplexsystemsproblem)toexamine,
inlitmustestfashion,theempiricalvalidityoftheCOP’s9-characteristicdefinition.
Second,weemployedtheSACSToolkit,whichweusedtoorganizethesuggested
listofCOPmethodsintoacohesiveframework.TheSACSToolkitisacase-based,
mixed-methodsplatformthatdrawsonthelatestadvancesincomputationalandcom-
plexitysciencemethodstomodelthetemporalandspatialcomplexitiesofcomplex
systems. For our case study we examined a network of 20 communities, located
inSummitCounty,OhioUSA.Inparticular,weexaminedthenegativeimpactthat
suburbansprawlishavingonthepoorercommunitiesinthiscounty. Ourdatabase
waspartitionedfromtheSummit2010:QualityofLifeProject.
Overall, we found the COP’s 9-characteristic definition to be empirically valid
anduseful.WealsofoundtheSACSToolkittobeaneffectivewaytoemployand
organizethemethodsrecommendedbytheCOPapproach.Nonetheless,someissues
didemerge. Forexample, theCOPapproachseemsalmostentirelyfocusedonthe
complexities of place. As such, it has yet to develop a sophisticated view of how
place, health and health care are intersecting complex systems. Also, while it is
vii
viii Preface
usefultothinkofplacesasagent-basedbased(Characteristic9),therearelimitsto
this modeling approach, such as its microscopic view of emergent social structure
and its restricted (rule-based) view of agency. Still, despite these challenges, the
COPapproachseemstoholdrealempiricalpromiseasausefulwaytoaddressmany
ofthechallengesthatconventionalpublichealthresearchseemsunabletosolve;in
particular,modelingthecomplexevolutionanddynamicsofplaces,andaddressing
thecausalinterplaybetweencompositionalandcontextualfactorsandtheirimpact
oncommunity-levelhealthoutcomes.
Acknowledgements
WewouldliketothankDeanSusanStockerandKentStateUniversityatAshtabula
foralloftheirfinancialandadministrativesupport.
ix
Contents
1 TheComplexitiesofPlaceApproach ............................ 1
2 DefinitionalTestofComplexSystems............................ 11
3 Case-BasedModelingandtheSACSToolkit...................... 15
4 Methods ..................................................... 27
5 PlacesAreComplex ........................................... 35
6 PlacesAreEmergentandSelf-Organizing........................ 39
7 PlacesAreNodeswithinLargerNetworks ....................... 47
8 PlacesAreDynamicandEvolving............................... 51
9 PlacesAreNonlinear .......................................... 55
10 PlacesAreSubjectiveandHistorical............................. 59
11 PlacesAreOpen-EndedwithFuzzyBoundaries .................. 63
12 PlacesArePower-BasedConflictedNegotiations .................. 67
13 PlacesAreAgent-Based........................................ 69
14 Conclusion ................................................... 75
References........................................................ 77
Index ............................................................ 81
xi
