Quantitative and Qualitative Methods in Assessing Health Inequalities - Essay Example

?COMBINING QUANTITATIVE AND QUALITATIVE METHODS IN ASSESSING HEALTH INEQUALITIES By 15th, December Word Count: 3479 Introduction This essay will focus on whether quantitative and qualitative methods can be combined in research regarding health inequalities. The essay will also include issues such as ontology, and epistemology in identifying the strengths, weaknesses of both qualitative and quantitative research methods. Several studies have been done in the field of health sciences to establish different aspects of health inequalities. Both qualitative and quantitative methods have been used but in most cases, the methods have been used separately. In this essay, the focus will be on how the two methods can be used mutually to minimize errors, which result from lack of identification of possible indicators that address the health inequalities in the UK. Such indicators include less number of potential respondents, lack of use of statistical measures that confirms the strong and weak identifies of the health inequalities and unavailability of data. Therefore, using mixed methodology will enable minimization of these errors resulting in generalized results that are applicable to average group of respondents. In the recent past, there has been increased interest on combining qualitative and quantitative research methodologies, also called mixed methods, in conducting research. Researches done using qualitative and quantitative methodologies separately are at times characterized by discrepant findings. Ontology refers to the existing information about a given phenomenon. On the other hand, epistemology refers to the ways that can be used to comprehend the existing facts about phenomena. Interrelationship between epistemology and ontology plays a crucial role in research. Therefore, it is important for researchers to be conversant with how the two aspects are interlinked. The appropriateness of integrating qualitative and quantitative research in health sciences research remains a debatable issue. However, qualitative and quantitative researches have been frequently combined in conducting sociological research. Moreover, health aspects that relate to the social life are frequently examined using both qualitative and quantitative research (Pope, et al., 2007, 147-152). Quantitative and qualitative research methods are characterized by several epistemological and ontological differences. Some researchers in health argue that only quantitative methods should be used in making policies used in tackling health inequality. Health inequality can be defined as the distribution of health status across the different classes in a population. According to Foster and Allison (2004), objective data regarding the health status of a population is often unavailable or incomplete for most population. Moreover, the available data is often self-reported. Self-reported health status (SRHS) comprises of data that reports the people’s own perceptions. However, SRHS is used as a predictor of health outcomes such as the rate of mortality. Nevertheless, SRHS averts use of tools such as distribution analysis in assessing health inequality (Allison & Foster, 2004). According to Asada (2007, 19-23), the urge to use mixed research methodologies has been triggered by the complex nature of the interactions concerning health services provision. In the past, research regarding health matters was mainly done using quantitative methods. However, qualitative techniques are increasingly becoming accepted in the field of health research. Currently, qualitative methods are often used on their own (Bracken, 2010). However, there is an increasing urge to combine qualitative and quantitative research in examining health related matters. Health provision is crucial in improving the welfare of individuals. Inequalities in health provision and access to health services are a continuing problem, which has resulted in the widening of the health gap in the last two decades. Health inequalities in a given population have negative impacts on the health outcome. The determinants of health and health inequalities have already been identified and recorded. However, there is lack of evidence on how the determinants can be addressed. Evidence on the measures that can be taken to reduce health inequalities is lacking. Moreover, there is insufficient information on the geographical distribution and ways to deal with the causes of health inequalities. Additionally, there is less information on why the economic inequalities persist and broaden in some populations (Bambra, et al., 2010). This essay is based on the idea that several manifestations of health inequalities have been witnessed in UK. However, further understanding of the level of inequality is required, especially on aspects such as formulation and implementation of public policies required in tackling the acknowledged inequalities. Although there has been general improvement in health provision, not all the social groups have benefited from such improvements. Moreover, it is still unclear if the existing public policies aid in reduction of these inequalities (Asada, 2007). Health inequalities can be defined as the existing disparities in aspects pertaining to structures used in health provision within a population or across the different social classes. Health inequalities are closely associated with the social determinants of health (Bambra, et al., 2010). Health inequalities have been identified as a threat to the policy makers since they are mainly caused by social factors, which are multifaceted. This requires the policy makers to collaborate with several agencies. Moreover, policy processes are poorly understood. This is a threat to current and future policies. Actually, some health and social policies have been known to increase the inequalities instead of reducing them. Moreover, there is no evidence on the effectiveness of policies in tackling health inequalities. Therefore, use of research to reinforce decisions regarding health policies are greatly endorsed (Exworthy, 2003). Research methodology entails setting up the guidelines such as the procedures to be followed in collecting and analyzing data. Whether using the qualitative or quantitative methodology, there must be, guidelines to enable the research adopt an appropriate procedure and obtain unbiased data. Methodology is used to refer to the tactics of approaching qualitative and quantitative research that have been developed by different schools of thought. Qualitative research mainly focuses on establishing the different kinds or the perspectives of people regarding a given topic (Asada, 2007). The research often entails answering the question “What is going on here?” For example, a study on the health inequalities in UK would entail studying the health delivery processes. While using qualitative method, the research would undertake a research to know aspects such as the proportion of people who believe that inequality exists in health provision or heath systems. If used appropriately, qualitative research is essential. Moreover, qualitative research can help researchers prepare or pave way for quantitative research. However, this does not imply that qualitative research is secondary to quantitative research. This means that the two research methods are closely linked. This is because quantitative research relies on qualitative method for explanations (Babbie, 2007). Qualitative methodology is a research methodology that tends to be subjective. In most cases, qualitative research relies on materials obtained from previous researches. The existing researchers are used in qualitative research to identify the core variables in a given research topic. Therefore, a research can opt to alter the research findings since qualitative research does not use statistical measures to identify and attest the data. Qualitative methodology is used to research phenomenon constructed through interaction between humans. Qualitative research methodology emphasizes on handling of issues in a holistic manner. The methods are suitable when the research question is open, exploratory and cannot be addressed using numeric data. The health process are quite complex and include numerous experiences that can only be explained using qualitative approach. Qualitative approaches used in addressing health related issues include interviews, observation, and use of focus groups in addition to analysis of existing texts. Qualitative data is analyzed using ethnography and phenomenology. Use of qualitative research enables the researcher to provide complex word-based descriptions regarding the experiences of people on a given research question. Therefore, the researcher is able to provide opinions, beliefs, emotions, behaviors, and inter-connectedness of different issues that surround a complex phenomenon. Another importance of using qualitative research is that it enables the researchers to identify intangible factors such as religious beliefs, which cannot be quantified. Moreover, qualitative analysis enhances analysis of complex reality of a given circumstance (Bryman, April 2006). According to Bryman (2007), qualitative research involves a number of steps. These steps include identification off the research question, collection of data relevant to the research question, selection of the site or place to conduct the research and establishing the theoretical framework to use in the research. This is followed by recording of the findings from which the conclusions are drawn. Qualitative research methodologies allow the researcher to obtain detailed descriptions from the participants. However, the research must evaluate the data collected to using different approaches. Therefore, qualitative research methodology enables the researcher to use their knowledge. The conclusions made using qualitative research are crucial in policy formulation. However, the findings might not be credible and reliable for effective policymaking since they mainly rely on participants opinions. However, usin quantitative research to analyse findings statistically enhances credibility (Bryman, 1993). On the other hand, quantitative research method is objective since it necessitates researchers to identify a clear goal referred to as the hypothesis before starting the research. Therefore, the data collected is used to ascertain or disapprove the goal. Quantitative research is based on positivist paradigm, which proposes that the world is made up of measurable facts. Therefore, using quantitative research yields harder data as compared to qualitative methods. Policymaking entails collection of data, which is analyzed to yield results that determine the concepts of a policy. Quantitative methods are often designed to find the connection between two variables, to attest a hypothesis or evaluate the research question. Quantitative data is analyzed to give numerical figures. For such data to be meaningful there is need for explanations, which are often given in form of words (Bracken, 2010). Qualitative research is increasingly becoming popular in health research. Qualitative research is able to produce unique contribution to the research findings. Moreover, qualitative research is more appropriate in some types of research. While conducting quantitative research, researchers do not have direct interactions with the participants. Therefore, quantitative methods are incapable of collecting first hand data, which is more reliable (Bryman, 2007). To understand the qualitative and quantitative research methodologies, it is crucial to understand the constructivist ontology and interpretivist epistemology. While conducting research using pure qualitative and quantitative research, researchers have at times pledged to diverse paradigm such as opinions regarding what constitutes reality, an aspect referred to as ontology. Moreover, epistemology constitutes an important aspect of health research. Quantitative researchers often base their perspectives on positivism (Exworthy, et al., 2003). Before conducting any research, it is important for the researchers to explain how their interest in the research topic developed. This could be through stating the issue or individuals who triggered them to conduct the research. This helps to articulate the standpoint of the researcher. This is crucial since the standpoint influences the different aspects of the study including how the researcher develops the research question. The standpoint determines the preferred research methodology, which is related to the ontological and epistemological assumptions of the researcher (Bryman, 1993). At this point, it is important to explain what epistemology and ontology mean and their influence in research on health inequality. Ontology refers to the available information regarding a given topic. On the other hand, epistemology refers to the ways in which the information regarding a given topic can be gathered. The interconnectedness between research methodology, ontology, and epistemology plays a critical role in research. This is because the researcher requires understanding ontology before starting the research. Moreover, the epistemology must be understood for the researcher to select a methodology that is appropriate for the research. Therefore, the ontology, epistemology and, methodology are closely related and play a role in determining the continuity of the research. Moreover, the three concepts must systematically follow each other (Babbie, 2007; Bracken, 2010). Constructive ontology aims at understanding how a phenomenon emerges due to interactions. This is due to the idea that some phenomenon are created through interactions. To interpret constructive ontology, interpretivist epistemology is required. Use of interpretivism enables the researcher understand how different people construct meaning. Therefore, ontology is more relevant in qualitative research where the research is founded on already established concept. Indeed, ontology entails what a researcher believes to constitute the reality. Therefore, the aim of such a research is to formulate the relationship between variables within the study (Bryman, 2006). Epistemology is closely related to quantitative research, which entails investigation of basic and distinctive factors. Therefore, epistemology is used in justification of the results through use of assumptions and facts. Actually, epistemology deals with the theory of knowledge since it assumes that the existing knowledge regarding a given topic can be known (Onwuegbuzie & Johnson, 2006). From the above explanations, it is clear that the researcher’s ontological stand affects the epistemological position. Moreover, the researcher’s epistemology affects the research methodology he/she chooses to use. Understanding the fundamental differences between quantitative and qualitative research is important since it will provides insights on the best approach to use in health inequality research. Moreover, the understanding establishes the possibility of combining quantitative and qualitative research in the aforementioned research. The qualitative and quantitative research is different on the approaches they use. However, the major difference exists in the ontological and epistemological grounds. In social sciences, the purpose and nature of the nature distinguishes the qualitative and quantitative researches. According to Babbie (2007, p. 26), the difference between qualitative and quantitative research is based on the numerical data produced by quantitative research as opposed to the non-numerical data produced by qualitative research. Depending on the data obtained, the researcher is able to measure the credibility and validity of the methodology. However, there are diverse assumptions regarding epistemology, which may affect the choice of research methodology (Bryman, 2006). Qualitative and quantitative analysis have their strengths and weaknesses. Therefore, there are advantages and disadvantages associated with combining the two methods in conducting research regarding health inequality. Moreover, there is a problem in choosing the methods to combine to ensure that the research problem is addressed appropriately. Qualitative research tends to be subjective since they focus on the inferences of the researcher. The inferences are based on how the researcher understands the data. This is because the data collected using qualitative methodologies is not converted to numeric. Qualitative research is mainly used in social science research. However, health research involves research on some social aspects and it derives some information from qualitative analysis (Pope, et al., 2007). Qualitative research originated from the attempts by scholars to generalize information while developing the hypothesis to test. Recent qualitative researches on health inequalities highlight the importance of public involvement in tackling inequalities in health provision. However, there is insufficient documented research finding on the exact role that the public can play in reducing the inequality. In qualitative research on health inequalities, methodologies such as ethnography, interviews and surveys have been used to examine the opinions of the public on health inequalities in UK. Most of the research has focused on the individuals likely to be victims of the inequalities (Bryman, 2007). Qualitative research helps in highlighting the interconnectedness of the different factors that affect health and the health provision. By using qualitative research, it is possible to identify the factors that differ in the different health provision situations. Such factors include the socio-demographic, attitude related factors and the behavioral factors. Research on health inequality has been extensive. This has resulted in identification of most factors such that it is unlikely that other factors will be identified. Therefore, most researches on health inequality are likely to be qualitative since this kind of research mainly relies on analyzing the existing data (Bolam, 2005). Quantitative methods are based on statistics and provide robust results especially if the researcher uses appropriate sample sizes. Additionally, regression analysis helps in controlling the outcome when number large of variables is involved in the research is large. However, quantitative research methods cannot provide contextual information and are thus incapable of fully capturing the causality. Quantitative research tends to be objective since the conclusions are grounded on the analysis of the data using statistical methodologies. Quantitative researches are more popular in heath research and are based on inductive approach as opposed to the generalization approach used in qualitative research (Curry, et al., 2009). On the other hand, qualitative methods, which include observations and surveys, are able to shed light on different aspects that may affect health provision. Such aspects include political factors, economic as well as social factors. Therefore, combining qualitative and quantitative methods is important since qualitative methods allow in-depth study of the particular issues that may arise when using quantitative research. Thus, qualitative research enables the researcher to understand the perception regarding (Exworthy, et al., 2003). For health promotion policies to be able to address the issue of the effect of social variations on health provision there is need for determination of the interface between social structures and the human agency. Interrelation between two variables is best addressed using quantitative research. However, the complexity that arises from incorporation of social aspects makes it hard for researchers to use quantitative analysis solely. Mixed method has not been used adequately in exploring the health inequalities in the society. In cases where both qualitative and quantitative research has been used together, the validity and reliability of findings have been questioned. This is because quantitative findings have at times questioned the existence of health inequalities. On the other hand, qualitative methods often demonstrate the existence of the inequalities, which results in opposition of the use of mixed method in research (Anderson, 2010). Since both qualitative and quantitative methodologies have their limitations, combining them ensures that the weaknesses are balanced. While quantitative data offers precision, the qualitative data helps the researcher to address how the different phenomenon operates. Moreover, quantitative methods do not allow for adequate data analysis. However, qualitative methodologies enable the researcher to interpret the data while integrating open-minded opinions. Qualitative methods data is thus used to explore and expand data obtained though quantitative research (Onwuegbuzie & Leech, 2005). While addressing the issue of health inequality, quantitative method can be used in answering specific questions. This is because quantitative research enables the researcher obtaining numerical data from a small sample that is representative of a large population. However, qualitative research cannot allow detailed analysis of the different aspects related to health inequality. Nevertheless, the researcher can use qualitative methodology in supplementing the numerical data obtained through quantitative measurements. Moreover, using qualitative method enables the researcher to draw comparisons between different elements causing or affecting health inequality (Carr, et al., 2011). The major quest of health inequality research is to enable policy makers determine the best approaches of dealing with the causes of the inequality. Moffatt, et al., (2006) asserts that factors affecting health provision are embeded and require use of both qualitative and quantitative research. The researchers argue that combining qualitaitve and quantitative research will enhance research on health inequality. Qualitative research will enable anzlyzation of the complex health service interventions. On the other hand, quantitative research will enable collection of facts regarding diferent factors that could be social, political, or economic. Therefore, the policy makers will rely on reliable and credible findings with deeper insights that cannot be produced if any of the two methods is used individually. Therefore combining the two methods allows researcher address the weaknesses associated with individual method (Exworthy, et al., 2003). Conclusion Health inequality is a complex issue, which requires researchers to understand the health status of individuals in a population. However, data regarding individual’s health status is incomplete or unavailable. Moreover, most of the available data is obtained through self-reported health status. Such kind of data is often complex and can suitably be analysed using qualitative methods. Detailed qualitative study of the aforementioned domain would introduce wide range of predictors in this regard that proves to be helpful in formulating the relevant hypothesis and data in order to evaluate the reliable and valid picture of health inequalities. Therefore, combining qualitative and quantitative methods would enable researchers address the issue of health inequality appropriately. Research tends to stimulate enactment of policies when it is translated in form of ideas. However, ideas differ from one person to another. Therefore, there is need for researchers to track and respond to evolution of ideas associated to research. The ontological and epistemological views regarding qualitative and quantitative research differ. These aspects affect use of either of the two methods in conducting research on health inequality. While formulating health policies, it is important to understand the different factors affecting health provision. One such factor is the distribution of health status across the different classes in a population. Over a long period, qualitative and quantitative research methods have been used separately with little overlap. However, there have been several innovations in the recent past, which have emphasized on the complementarity of the qualitative and quantitative methods. Most researchers argue that combining qualitative and quantitative research methods results in greater insights since it is possible for the researchers to confirm the findings using the different methods. This improves the validity of the research. In policy formulation, the effectiveness of the policy greatly depends on validity of research findings. Therefore, mixed method, which includes combined qualitative and quantitative methods, enables researchers formulate policies that address the intended issues. Works Cited Allison , R. & Foster , J 2004, Measuring Health Inequality Using Qualitative Data, Journal of Health Economics, 23(3), pp. 504-524. Anderson, C 2010, Presenting and Evaluating Qualitative Research, American Journal of Pharmaceutical Educucation, 74(8), pp. 141-143. Asada, Y 2007, Health Inequality: Morality and Measurement, University of Toronto Press, Toronto. Babbie, E 2007, The practice of Social Research, 11 ed., Thomson Wadsworth, Toronto. 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