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Hierarchy theory and epidemiology : a narrative critique

Wilby, Jennifer, 1953


Jennifer, 1953 Wilby


Integrating approaches from systems thinking with the methods and tools from the discipline of epidemiology, at the level of the management of international health policy and emerging (and reemerging) infectious disease (EID), the subject of this thesis, is a novel approach. The aim of integrating these approaches in this thesis was to provide additional insights into the management of EID, alongside the aims of enriching the practice of both systems and epidemiology.

This thesis proposed that applying a systemic approach using systems thinking (and specifically the systems approach that addresses problematical situations from a hierarchical perspective) in combination with existing epidemiological knowledge, could provide an enriched description for the modelling, planning, intervention, and response in an analysis of international guidance in public health policy-making. This research was undertaken using a multi-disciplinary multi-paradigm approach of combining the systematic review process with critical systems thinking to explore a functionalist and interpretive approach to hierarchical systems thinking.

There are several outcomes from this research: 1) The compilation of a comprehensive narrative of published work on hierarchy theory and those areas of epidemiology relevant to this study; 2) a process for critical systematic review; 3) a narrative review and critical systems thinking analysis of functionalist and interpretive hierarchical approaches in complex systems; and 4) a critical reflection on the usefulness of combining these hierarchical systems approaches with methods and data from other disciplines; in this case, epidemiology and the study of EID.

This research has shown that there are contributing risk factors in the emergence of infectious disease not addressed in current policy making procedures for EID. The implications of this are important in reviewing current EID policies. Further work in this area is suggested to investigate whether the functionalist and interpretive hierarchical analysis is feasible in other complex systems, and in further investigating the philosophy, principles and practice of this multi-disciplinary approach.


Wilby, J. 1. (2007). Hierarchy theory and epidemiology : a narrative critique. (Thesis). University of Hull. Retrieved from

Thesis Type Thesis
Deposit Date Sep 20, 2016
Publicly Available Date Feb 23, 2023
Keywords Business
Public URL
Additional Information Business School, The University of Hull
Award Date Jan 1, 2007


Thesis (51.6 Mb)

Copyright Statement
© 2007 Wilby, Jennifer, 1953-. All rights reserved. No part of this publication may be reproduced without the written permission of the copyright holder.

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