
D. A. V. BROWN
The new theoretical thrust calls for an interpretive-critical
dialogue that would represent a shift from the First World of-
fering of technical expertise to the Third. This offering is based
on the positivist mis-analysis of society and economy associ-
ated with neo-classical economics. The shift would enable an
elucidatory interchange between both areas of an increasingly
interconnected globe (Preston, 1996: pp. 329-330). This should
be based on an understanding of social scientific enquiry de-
void of argument by analogy between the natural and social
sciences. In its place would be one that draws more on herme-
neutic approaches to further the understanding of local percep-
tions and interpretations of what is deemed to be a much more
complex process of social change than was previously thought.
The qualitative case studies used in the CDB studies provide
a wealth of insight into the character of the society in which the
individual lives. They tell of the social, cultural, economic,
political and historical setting of which the respondent is a part.
They also tell of the nature of the social relations and social
network of the individual; how they have lived their lives; the
decisions they have made and continue to make on a daily basis;
and the interplay between culture, personality and society. The
nature of these relations is, in part, a product of the inequalities
that are related to the existence of poverty. They in turn serve to
reinforce and perpetuate poverty. In sum, the interviews tell us
of the circumstances that led to persons finding themselves in
situations of insufficiency. They also tell of how people cope,
adapt and adjust to such situations. At the end of the process an
understanding of how deprivation has found expression in the
lived experiences of the individual is obtained.
Resolving the Epistemologies: Fitting Quantitative
and Qualitative Data
The quantitative data gleaned by the formal survey and
household questionnaires and the data gleaned from the in-
depth household interviews are of course based on different ap-
proaches to the study of social reality (Polkinghorne, 1983: pp.
22-23; 1988: pp. 7-8) It is important though that the comple-
mentary nature of the two types of data be understood (Patton,
2002: pp. 49, 69). Einstein’s famous quotation tells us that, “not
everything that can be counted counts and not everything that
counts can be counted”.2 Joseph Stiglitz warns against making a
“fetish out of metrics” (Stiglitz, 2009). These arguments seem
to suggest the need for the creative application of both qualita-
tive and quantitative methodologies in social research to ad-
dress questions that causal-explanatory and interpretive-cons-
tructivist epistemologies cannot answer by themselves.
Their co mbination, it would seem, can lend much to enhanc-
ing our understanding of the causes and sustainers of social
issues such as poverty as well as some of the corrective meas-
ures that can be employed in the area of policy. This can hap-
pen in two ways. Firstly, qualitative data in the form of ex-
tended discussion on a topic can alert us to measurable issues
that are of significance that have not been measured. Secondly,
qualitative data can enable us to understand meanings attributed
to experiences that simply cannot be measured or quantified
and yet are important for social outcomes. In the case of the
Grenada data, two substantive issues are examined to see the
extent to which their expression, as qualitative data, brings to
the fore linkages between the variables that are not immediately
obvious from an examination of the quantitative data. The is-
sues are as follows:
1) Chronic illness and poverty; 2) intergenerational poverty,
gender and the segme nted labour mark e t .
Chronic Illnesses and Poverty
In the analysis of the quantitative data gleaned from the
household surveys of reported health in the Caribbean the poor
have tended to report better health than the non-poor (Brown,
2006: pp. 55-77). This odd finding on reported health from the
surveys points to a number of structural constraints and the
kind of adaptation in attitude that is made by the poor of the
region. Lack of resources means an inability or, at the very least,
difficulties in accessing good quality medical care. This, cou-
pled with the preoccupation with “making two ends meet”, and
a lack of knowledge about human physiology serves to under-
mine the development of a “check-up” culture, or a preventive
approach towards health care. So, even as they report no ill
health in the surveys the disease is often at work, but not yet
manifest.
The Case of Ms. Wendy
This relationship between chronic illness and poverty that is
obscured by the analysis of quantitative data is brought out
quite clearly in the qualitative. This takes the form of the narra-
tive that comes out of the in-depth interview conducted with Ms.
Wendy, a 54-year-old single mother of 9. Her illnesses are
chronic, lifestyle-based, silent killer diseases. Given her stress-
ful circumstances of deprivation, low levels of education and
her health care seeking behaviour it is perhaps no wonder that
she came down with the two diseases that she did and that they
both took her by surprise.
When she is interviewed, Ms. Wendy provides insight into
the nature of her health seeking behaviour and how it might be
related to the underestimation of the incidence of the silent
illness by the poor. She indicates that she does not go to the
doctor unless she is feeling unwell. The nature of chronic non-
communicable illnesses, such as hypertension, diabetes and the
more immediately life threatening cancer, is such that to wait
until symptoms start appearing is usually too late to take effec-
tive control of the disease. She attributes her approach to health
care to the hardship that she faces in life and the difficulty she
encounters, on a daily basis, in providing the basic needs of her
life. In addition to material deprivation, in many instances the
daily tasks of the working poor are so consuming that they find
themselves suffering serious time poverty as well. Health con-
cerns that are not immediately disruptive to their routine are
unlikely to be at the top of their agenda when it comes to deci-
sions relating to the daily allocation of time specific tasks. The
unfortunate thing, as Ms. Wendy discovers, is that delaying
health care seeking now is likely to lead to greater illness later
on. Therefore, even as the poor are becoming more unwell as a
result of these chronic illnesses, the quantitative data are indi-
cating that their health status is better than the non-poor. This is
illustrated in Table 1.
The table is based on self-reported information. It reveals, in
the case of the silent, chronic illnesses, what appears to be a
serious undercount on the part of the three lowest quintiles. The
undercount is particularly pronounced in the case of the poorest
quintile, the one in which Ms. Wendy would fall. Note that in
the case of asthma, which is a very “noisy” disease, the socio-
economic differential virtually disappears. This means that the
2Sign on the wall of Albert Einstein’s Princet on office .
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