Robin Durie

Connecting communities and complexity: a case study in creating the conditions for transformational change

The standard, deficit-based, approach to health promotion tends to focus on health problems, designing services which are meant to solve these problems, of which members of communities are made the passive recipients. An alternative approach recognises that health problems are complex, having many causal pathways and as a result will require locally tailored interventions, involving multiple service providers working with local communities. Using empirical research from the development of two transformational community-led partnerships, an experiential learning programme was developed, Connecting Communities (C2). Complexity science is the underpinning theoretical framework for C2, which seeks to create the conditions to transform the health and well-being of disadvantaged communities. C2 focuses specifically on the nature of the relations between the agents in the system and their interactions with the social environment which determine the system’s behaviour. This is because a key tenet of complexity science is that systemic change cannot be externally directed, but occurs as a result of the self-organising interactions and relationships within the system. C2 takes an explicit asset-based community development approach, seeking to facilitate and support the development of local neighbourhood partnerships which focus on the strengths and aspirations of the community, rather than perceived deficits. This paper reports on the development of C2, its delivery, presents a case study of one of the first groups to undertake the Programme, and assesses its subsequent impacts on the participants’ ways of working, and in the local community.

Healthy publics: enabling cultures and environments for health

Despite extraordinary advances in biomedicine and associated gains in human health and well-being, a growing number of health and well-being related challenges have remained or emerged in recent years. These challenges are often ‘more than biomedical’ in complexion, being social, cultural and environmental in terms of their key drivers and determinants, and underline the necessity of a concerted policy focus on generating healthy societies. Despite the apparent agreement on this diagnosis, the means to produce change are seldom clear, even when the turn to health and well-being requires sizable shifts in our understandings of public health and research practices. This paper sets out a platform from which research approaches, methods and translational pathways for enabling health and well-being can be built. The term ‘healthy publics’ allows us to shift the focus of public health away from ‘the public’ or individuals as targets for intervention, and away from the view that culture acts as a barrier to efficient biomedical intervention, towards a greater recognition of the public struggles that are involved in raising health issues, questioning what counts as healthy and unhealthy and assembling the evidence and experience to change practices and outcomes. Creating the conditions for health and well-being, we argue, requires an engaged research process in which public experiments in building and repairing social and material relations are staged and sustained even if, and especially when, the fates of those publics remain fragile and buffeted by competing and often more powerful public formations.

Issues in Husserl's Ideas II, eds. Thomas Nenon and Lester Embree

and without expectation of reciprocity, that we may observe the self in transcendence. Such then is Schrags portrait of The Self after Postmodemity, a discursive, active, social self which, with the aid of transversality is able to unify itself without resort to substance or substratum, reflect critically without recourse to a universal essentialism or foundationalism, and transcend itself without a metaphysical absolutism. I would strongly recommend this book as a much needed antidote to one currently prevalent and somewhat unhelpful reading of the deconstructed, postrnodem subject. Simon V. Glynn Florida Atlantic University