Qualitative and quantitative research in social epidemiology: is complementarity the only issue?

Although in recent years there has been a growing acceptance of qualitative research in social epidemiology, the role and scope of its use remain a contested terrain. We sketch some of the issues that have been the focus of the debate between supporters and critics of qualitative research in social epidemiology and adjacent public health disciplines. They include epistemological problems, such as the limitations of survey research to uncover social mechanisms, lack of background among epidemiologists to generate sound hypotheses for specific populations, and ontological problems such the idealism inherent in some of the qualitative research coming from anthropology. Next we review the urban ethnographies of Elliot Liebow's and a decade of population based research in African American and low income neighborhoods in the United States to expose another role for qualitative research in social epidemiology. Thus, we argue that qualitative research has been used in scientific debates that confront egalitarian researchers with institutions or peers with opposing economic interests and ideologies. Qualitative research is often a powerful tool to fuel alternative theoretical frameworks and measures to be included in quantitative population based surveys. We confine this use of qualitative research to the academic world and do not necessarily imply that communities benefit from it as in action research.