复杂理论视角下城市健康地理学探析

城市公共健康问题是根植于所依托的地域空间背景下的复杂问题,因而,目前学界主要以还原论的模型假设来分析影响城市健康的复杂多因子关系时存在一定局限。本文在分析城市健康地理问题的"地方"复杂性基础上,提出用复杂理论认识城市的健康问题,将城市健康地理系统看作为具有开放性、组分的知识局限性、自组织性、路径依赖、涌现性、正反馈和锁定特征的复杂系统。从复杂理论视角探讨了当前城市健康地理学研究的三个主要议题,进而提出复杂理论视角下城市健康地理学研究框架及未来研究展望。

PROGRESS IN URBAN HEALTH GEOGRAPHY USING COMPLEXITY THEORY

Medical geography shifted its focus from the geographical distribution of diseases to a wider concept of health in 1990s. Health geography then has gradually developed as a new branch of medical geography. The urban public health problems are complex and rooted in the complicated geographical spaces. However, the academic community has been mainly analyzing such complex multi-factor relationship for decades by using models and hypothesis from the perspective of reductionism. Since the effects of proximity to disease sources on health are nonlinear and the existence of triads of urban space results in health inequality, the reductionism has certain limitations to capture these complex nonlinear and nested relationships between multiple health indicators. Employing the complexity theory, this paper aims to understand the urban health system as a complex system with fundamental attributes such as openness, components with limited ‘knowledge’ of each other, self-organization, path dependence, emergence, positive feedback, and lock-in. It analyzes the mechanisms in urban health geography from the perspective of complexity theory and the production of space. Under the interaction of the built environment, urban administration policy, and social space, the dynamics of individual health are affected by the internal factors at city level and the external factors at regional and global level. Three types of health outcomes, disease transmission, chronic diseases and mental illnesses are finally formed. Complex theory can be used to analyze three major issues in urban health geography, urban environmental exposure and urban residents' health, urban health care and medical policies, global environmental change and urban residents' health risks. This paper proposes a conceptual framework to study urban health geography from the perspective of complexity theory. It includes three stages and two processes.