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http://heb.sagepub.com Health Education & Behavior DOI: 10.1177/1090198104265597 2004; 31; 441 Health Educ Behav Marshall W. Kreuter, Christopher De Rosa, Elizabeth H. Howze and Grant T. Baldwin Understanding Wicked Problems: A Key to Advancing Environmental Health Promotion http://heb.sagepub.com/cgi/content/abstract/31/4/441 The online version of this article can be found at: Published by: http://www.sagepublications.com On behalf of: Society for Public Health Education can be found at: Health Education & Behavior Additional services and information for http://heb.sagepub.com/cgi/alerts Email Alerts: http://heb.sagepub.com/subscriptions Subscriptions: http://www.sagepub.com/journalsReprints.nav Reprints: http://www.sagepub.com/journalsPermissions.nav Permissions: http://heb.sagepub.com/cgi/content/refs/31/4/441 Citations at SAN FRANCISCO STATE UNIV on August 26, 2009 http://heb.sagepub.com Downloaded from
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10.1177/1090198104265597 ARTICLE (August 20 4) Kreuter et al. / Understanding Wicked Problems August Understanding Wicked Problems: A Key to Advancing Environmental Health Promotion Marshall W. Kreuter, PhD, MPH (Hon) Christopher De Rosa, PhD Elizabeth H. Howze, ScD, CHES Grant T. Baldwin, PhD, MPH, CHES Complex environmental health problems—like air and water pollution, hazardous waste sites, and lead poi- soning—are in reality a constellation of linked problems embedded in the fabric of the communities in which they occur. These kinds of complex problems have been characterized by some as “wicked problems” wherein stakeholders may have conflicting interpretations of the problem and the science behind it, as well as different values, goals, and life experiences. Accordingly, policy makers, public health professionals, and other stake- holders who grapple with these problems cannot expect to effectively resolve them by relying solely on expert- driven approaches to problem solving. Rather, they need to acknowledge that wicked environmental health problems are most likely to yield to (1) the application of effective communityhealth promotionskills, (2) a sus- tained commitment to sound toxicological and epidemiologicalscience, (3) the application of systems thinking, and (4) transparent communication among all stakeholders. Keywords: environmental health; health promotion; wicked problems; tame problems; stakeholder involvement THE ECOLOGICAL PERSPECTIVE Health status and quality of life are influenced by a combination of factors including genetic predisposition, the environment and conditions of living, personal action or inac- tion, and a variety of social and economic factors often referred to as social and economic determinants of health. 1,2
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