The flow of the social: Developing a constructal systemic approach to the study of health inequalities

Society is a dynamic, living system. People, groups, institutions, and cultures are intricately interconnected. Changes in one area of society create changes in other areas. Causes and results may be closely linked or separated by time and space. Sociologists readily acknowledge this dynamic reality. However, our mainstream theories and methods often fail to account for it.;Even after decades of research into social inequalities in health, medical sociology still seems far away from being able to offer any definitive ideas about why such inequalities exist and persist despite efforts to alleviate them. Medical sociology (and sociology in general) is centered on a Western, individualist paradigm. This paradigm maintains the primacy of the individual, even in the face of a social science that fully acknowledges and purports to study a society that exists at a supra-individual level. The result of the Western individualist approach is a sociology that is increasingly essentialist, static, context-specific, linear, and symmetrical, even while professing a worldview contradictory to these traits.;The central question of this dissertation is how medical sociology can shift perspective and find a way of thinking about the social that not only acknowledges a dynamic, living social, but takes full account of it in sociological theory and methodology. A proposed solution to these difficulties is the development of a "constructal systemic approach" to the study of health inequalities, a sociology of dynamic, constructal flows in which society and social structures are seen as multiplicitous systems of converging and diverging flows, within an environment of other flows, both natural and social. Importantly, these flows are dynamic, ever moving, ever evolving, and continually changing. Individuals are moved from the center of inquiry and are seen as part of the environment of the flow system. This is a radical break from Western individualism where we are taught to see things, especially people, as individual, separate entities.;This constructal systemic paradigm is developed from a synthesis of ideas from Gilles Deleuze and Felix Guattari, Manuel DeLanda, and Adrian Bejan situated within a context of system dynamics. A new sociological paradigm is presented that leads to asking new questions from a new perspective.