Complexities that arise in social epidemiology suggest that a qualitative emphasis could be explored.
First, we have the issue of the meaning of the stock in trade factors related to socioeconomic status (SES). As indicated well in qq, the level of education, to pick one measure of SES, can mean quite different things if you are an immigrant whose educational qualifications in your country of origin don’t count than if the same level of qualification were achieved in this country. Conversely, the same income level, to pick another measure of SES, can mean quite different things if you are part of a family of immigrants that is living and working together in cramped conditions with an eye to accumulating savings and starting a business than if you are simply a poor native of this country. Official data sets are not well designed for teasing out such differences, yet a qualitative emphasis on the meaning of SES for individuals could help explain variation in health outcomes or in “upstream” variables, such as use of health care.
Contextualized meaning of SES variables blends into considerations of the awkwardly named “social capital.” What connections—and confidence or persistence built on a lifetime’s experience of connections—do you bring into your responses to health challenges? Quantitative measures of social capital, such as church attendance (on the assumption that this connects you with many people in your community), can be factored into a quantitative analysis. A qualitative emphasis might, however, allow exploration of what you really do to foster and then draw on social connections.
Both examples are instances of exposing the heterogeneity of subjects otherwise grouped into the same levels of a set of quantitative measures. Heterogeneity is an even larger issue than these examples indicate, in ways that a qualitative emphasis can begin to address. To be continued.