Podcast series from the MRC/CSO Social and Public Health Sciences Unit, University of Glasgow.
Ruth Dundas:
Welcome to 15 minutes on Health Inequalities and a podcast discussing the future of public health with some PhD students. I'm Ruth Dundas, Professor of Social Epidemiology at the MRC/CSO Social and Public Health Sciences Unit at the University of Glasgow. Today our podcast is a little bit different from usual. Instead of interviewing one person, we meet individuals who are shaping the future of public health. So this is a conversation between me and four people representing the next generation of public health researchers. They're all PhD students at the Social and Public Health Sciences Unit and with me today are...
Katja Kraljević:
Hiya, I'm Katja Kraljević and my research looks at workplace well-being in the European Union.
Danny Bradford:
And I'm Danny Bradford and I'm researching child health inequalities.
Kirsten Hainey:
Hi, I'm Kirsten Hainey and my research looks at gender identity and mental health.
Diego Andrade:
Hi I am Diego and my research looks at deprivation in Ecuador.
Ruth Dundas:
Welcome all of you. In population health, we are always being asked for innovative solutions that will improve public health and reduce health inequalities and at the same time, we do need to look forward to the next challenges on the horizon and really to do this properly, everybody needs to have a voice and especially young people and those early in their public health careers. So this podcast hands over the microphone to Katja, Danny, Kirsten and Diego. Really, so that we can hear their experiences, their perspectives and opinions on how the next generation sees the future of public health. So just a question to get us started...Is there a way that we can create pathways to give more power to students and early career professionals?
Katja Kraljević:
I mean, definitely. But I also think that part of the solution is making our own pathways for change instead of just waiting for them to be provided to us. My personal advice to other students and early career researchers is that if you see someone working on something that's really interesting or that you'd like to be involved or that you want to learn more about, just reach out to them. Look for collaboration opportunities anywhere you go, whether that's in the department that you work or in other universities that you visit or in other research institutes. It can be pretty scary at first, especially when you might be the least experienced person in the room, but you might really end up working on a project that becomes very important to improving other people's health.
Kirsten Hainey:
I agree, Katja, and I think it even extends beyond our own research context, but to the wider research environment. As students and early career researchers, we can act as a fresh pair of eyes, and when we enter the research world, and I think we're quite well placed to identify opportunities for change and for improvement within our organisations and addressing culture and values. As a collective, early career researchers, we've got such a powerful voice to advocate for change. And I think it's important that we harness that - really to ensure that research environments are becoming more inclusive and nurturing of us as early career researchers.
Ruth Dundas:
Do you think this falls to the individual researcher to seek these opportunities?
Kirsten Hainey:
No, no, not solely or absolutely. Institutions should be welcoming the sort of disruption that early career researchers and students will bring. And it feels like there's a potential win-win; organisations can benefit from the perspectives of new researchers and students. And researchers can develop skills advocacy and collaborative working. All these will be vital for our future careers as public health leaders.
Ruth Dundas:
And is there anything that institutions should be doing or they could do more of like to allow students and early career professionals to be that driver for change?
Katja Kraljević:
Certainly, I think institutions could organise more events where students and ECR's can network as a way forward, but I think that they can also do more to expand accessibility in the existing events that are already being organised and happening. For instance, reduced conference registration fees for students to make it more accessible. Or more local events that people can travel to easily, and I see some conferences also do reduced fees or free fees if you are a researcher from a low income country, which I think is really great because we get much more of those perspectives in the room that we need to hear.
Danny Bradford:
Yeah, I'd agree, I think the equity issues around students who don't have particularly large training budgets and those coming from social deprivation is really important. And I think one thing that the Unit here does very well is to support students to go and get wider experience outside of academia to support placements and internships. I think particularly if you can get into policy-making organisations, that can be really valuable.
Ruth Dundas:
Currently, you're PhD students in a research environment...how would you see your involvement in policy and decision making in the future?
Diego Andrade:
Well, I would see my future in two ways. First, as an academic researcher looking to contribute to the analysis of some of the most important health issues. For example, in my country or in the entire continent. But I am being prepared and praying in some of the top-of-the-line techniques for analysing how the inequalities and policies that will certainly shed light on associations, causes and probable solutions to the problems that face Ecuadorian populations, especially the poorest ones.
Ruth Dundas:
Does that mean that you see your role as a researcher influencing policy through the impact of your research?
Diego Andrade:
Well, yes, in the main. But secondly, I see my career as also contributing to the preparation of the future generation of health researchers, for example, being a faculty member. My experience at the University of Glasgow is helping me in the upskilling of our profile, not only as a researcher but also as a teacher and I foresee bringing back the knowledge to the students in the Masters programme we had research back in my country.
Kirsten Hainey:
That point about capacity building's really interesting Diego and when I finish my PhD, I'll be returning to clinical public health training NHS and I see one of my roles to be sharing that academic skill with clinical colleagues, just to ensure that everyone is benefiting from research and that it's implemented in clinical public health practice.
Danny Bradford:
I've come to public health actually from frontline support work and a postgraduate degree in psychology. And the longer I spend looking at health and well-being has just become more and more aware of how important very high-level systemic factors are. So rather than the individual behaviours and that's in keeping with the theme of day one in the European Public Health Week about health being a political choice. And some effective political ideologies really do underpin so many health issues that affect people's daily lives. So in the short term, I think I will stick in academia at first looking for postdocs and potentially fellowships. But in the longer term, I certainly hope to end up contributing to policy decisions that can have more practical and direct impacts on health if possible.
Ruth Dundas:
Danny, you talked a little bit about career development there, so staying on that theme, how do you find fulfilment in your public health career?
Danny Bradford:
For me, it's really important to be mindful of my values and and I can see the end goal of improving health and just being aware that it's very easy to get caught up in tunnel vision of whatever current project you're working on and boxes you might have tick for career progression and promotion and whatnot. And that's completely understandable given how precarious employment can be, particularly in academia. But I do think it's really important to check in now again on your values and see how they change over time and how that then impacts on where you and your work fit in kind of in the grander scheme of things.
Katja Kraljević:
Yeah, I agree with that, Danny. I think we have to consider carefully the social and moral impacts of our research, especially for those of us who are conducting our research in countries with more institutional funding and more support. And I think it's important for us to be as inclusive as possible and reflect the experiences and views of those whose voices have been heard less, not only as participants, but also as researchers themselves. And if something's missing, it becomes our responsibility to fill in those knowledge gaps. Because we're so lucky to have so many resources available to us, and I think that is a really wonderful thing. Occasionally intersectional research gets criticised as being part of identity politics or taking a political stance and something that should be clinical and objective. But I do think it's important to consider the subjective perspectives too. So how do different facets of somebody's identity, age, race, gender, sexuality, disability, religion, citizenship. How do they all play a part in people's experiences of poor health and well-being? And what policies can we implement to see immediate and long-term changes for the better for people who need it most? And at first I think it's kind of uncomfortable to have these conversations because we analyse our privilege or lack thereof through a different lens, and you feel a bit awkward and you don't know what to say or where to start or what's the right or wrong thing or how to approach it. But Europe's becoming more diverse, especially among young people, and to keep early career researchers engaged, as well as attract more young people to public health research, I think we need to keep on talking about these issues.
Danny Bradford:
Yeah. As Katja said, it can be really uncomfortable to ask questions of yourself and where you sort of you stand and where you fit in in the world. But I think you can create choices based on your principles. It will make a much more satisfying life and hopefully a feeling that at the end of the day, you've left things in a better state than you found them.
Ruth Dundas:
How would you then implement that during the research process? I suppose what I mean by that is, is there anything practical that people can do?
Kirsten Hainey:
Yeah. I guess at the individual level, even though I'm in the early months of my research, at the moment I've already found that engaging with patient and public involvement is really beneficial. It has helped shape my research, it's improved my research and it's helped address those issues that are of greatest relevance to the research subjects and stakeholders. The increasing importance that's been put on this kind of engagement with communities affected by research feels like a really valuable step in addressing some of the social and moral issues that might arise with our research. Especially where our work addresses populations that might be marginalised. And I guess in the wider sort of context and reflecting on recent experience of induction as a PhD student, it's of note that there's such an emphasis really placed on the importance of ethical practice when we're designing our research and we're considering the research process. I guess there's less emphasis placed on the importance of understanding this wider context and the wider implications, ethically of our research and the responsibility that that puts on us as researchers.
Ruth Dundas:
So thinking about that, what part of the status quo is the most frustrating, and how would you change it?
Kirsten Hainey:
I guess for me, one of the most positive byproducts I guess of the pandemic was the sense of urgency that we need to generate action for evidence and we need to be more accepting and tolerant of innovative solutions. And I'm not certainly not advocating for another pandemic. But I think there are positive lessons that we should take away from, from our experience during the pandemic, particularly around working flexibly and being more adaptive to change. And I think that'll be really useful in the future of public health research.
Diego Andrade:
I completely agree with you, Kirsten. We need to adapt and seek innovative solutions to tackle health inequalities. For example, one of the main problems can researchers face nowadays, especially in low income countries, is the lack of publicly available information for research purposes. On one hand, it is critical to preserving, guarding from personal sensitive information, but on the other, we need to have the information in the raw input for research. We need to have a balance between both sides, you know, and that requires innovative solution for handling held data. The University of Glasgow, for example, is doing through the study project is collaborate with local universities and research institutions to study the distributional agreements with data sources, promote the use of adequate protocols for finding personal informations that can be linked to other sources, and that gain valuable insights.
Katja Kraljević:
I completely agree with both of you. Both on the agile working aspect and also on improving access to information for research purposes. I think the long and short of it is really that we need to stop making researchers jump through hoops to be able to do their work.
Danny Bradford:
On a slightly different note, I guess. It might just be my own naivety as well, but it just feels there's a lot of time. There's a lack of translational work being done. We know so much about so many topics, but it just seems to lack of focus on putting these things like into practice and really making change and there's a tendency almost with mental or inertia just to continue doing similar research with minor tweaks. Obviously primary research has to continue and it does have value. I'm not denying that, but sometimes it does feel that institutions and major funding bodies kind of risk concentrating too much on self propagation and prestige than really affecting people's lives and making positive changes in health or the balance between these two things is maybe not ideal. We'll see.
Ruth Dundas:
That’s really interesting. That sort of like range of perspectives challenging the status quo there. We usually finish our podcast by asking ‘what are the implications for health inequalities?’. But I think from the conversation that we've had today, I would really want to know more about what can researchers or policymakers, what do they need to do to tackle inequalities?
Kirsten Hainey:
I mean the future holds so many significant challenges for public health; climate change, the ageing population, emerging disease, economic challenges, to name but a few. All of these are inevitably going to impact on health inequalities and addressing these issues will really require strong public health leadership.
Danny Bradford:
Yeah. And I guess personally, when we find ourselves potentially in that position is to ask the questions and not just the research question themselves, but then to ask, do those research questions matter? Are they worth asking? And if so, how can we implement the potential results and consider effective ways of implementing within the current systems and bureaucratics which do exist as well?
Diego Andrade:
Moreover, we should start recognising that health is actually a planetary issue, not only an individual local phenomenon. Our actions could have impacts on millions of people around the world.
Ruth Dundas:
What a way to finish, Diego. Thank you. That was a really inspiring episode. Thank you so much to Katja, Danny, Kirsten and Diego. Public Health is in good hands and I think working together, learning from each other, we can really pave the way for a healthier future. So thanks everybody. Participants in the podcast and some information about some of the projects can be found in the podcast notes. Thank you all for listening.