Tag Archives: duke medicine

Engaged in Thought

cenrAugust 23

I was fortunate enough to attend the “Engaging Patients, Families and Communities in all Phases of Translational Research to Improve Health” Conference this past Thursday and Friday because it stimulated some serious thought and discussion amongst attendees, but most importantly myself.  Conferences are usually worthwhile because attendees are typically doing similar work.  An added feature is the sharing of ideas, best practices and stories – the dreaded “networking” – can actually be broken down into genuine conversations about helping each other perform their respective careers better.  Most conferences meet this basic expectation.  But this one was different.  It went above and beyond my expectations for several reasons, which I will describe below.

First, the size of this conference was extremely manageable.  Roughly 200 attendees registered to attend and all but a dozen or so made it to Bethesda to hear keynote speaker Dr. Chris Austin kick off Thursday with laughter and thought-provoking questions.  Out of the 180+ that attended, I can safely and confidently say that I was able to engage with 20 of them in meaningful conversation regarding potential opportunities to collaborate in the near future.  Contrast that with a larger conference, say APHA’s annual conference of a massive 30,000+ attendees, and it’s no wonder why attendees stay within their subsections and specialties.  This conference provided me with ample opportunities to engage with and learn from professionals doing completely different work.  And that to me was particularly valuable.

I touched on it earlier, but I was very impressed with the wide range of experts in the field of public health and community-based research.  One group showcased their work to improve health outcomes in Amish communities and another described relaying crucial health communication messages via text messages in rural health clinics at various sites in Kenya.  Talk about learning opportunities!  And this is my favorite way to learn – seeing problems being solved in the field as they relate to the realities of life and then interacting with the investigators to learn how these interventions could be replicated to improve health in other populations.

Lastly, the agenda was designed to introduce ideas via speaker presentations then move into smaller breakout groups to tackle more specific questions.  One specific breakout session that I attended dealt with the ethical implications of community-based research.  Here were a few questions that were left in my mind to sort out post-conference as I continue working at the community level:

*As researchers, what value can we provide back to communities in exchange for critical research data?  

*How can we make the relationship more mutually beneficial?

*What if the research results did not shed the community in a particularly positive way – think of the negative implications that could arise if the media reported on those same results

*The idea of research and the value of official academic research compared to “findings” or “observations” seen in communities…is one necessarily better than the other?

For the reasons aforementioned, I personally thought this conference was very valuable to my work as a public health professional.  But, similarly, it also leads me to think that much more work needs to be done outside of our own “public health bubble.”  Dr. Austin of the National Center for Advancing Translational Sciences at the National Institutes of Health illustrated this with a simple, yet extremely profound anecdote.  He described meeting with members of Congress recently and one of the members asked him about his work in linguistics.  Apparently that member read translational sciences in the title of his division and assumed it was translating language rather than public health science.  Viewing this from a public health lens, I would shake my head and laugh.  But viewing this outside our “public health bubble,” I probably would have said the same thing or asked, what does this really mean?  Even in my own experiences when trying to explain what public health is to people from all walks of life, to put it simply, it is a complex conversation to have.  Which is why I strongly believe that we as public health professionals need to do a better job at relating to and forgiving others for not understanding ideas and concepts from our perspective.  One example of this is public health funding.  Public health funding was increased under the support of President Obama and written into the Affordable Care Act back in 2010.  Shortly thereafter, resulting from the many tumultuous battles to reduce federal debt and annual federal budgets, public health funding was the first on the chopping block.  Many members chose to redistribute funds previously appropriated for public health work to budgets of the Department of Health and Human Services.  The same funds which were originally set aside to boost prevention efforts in communities nationwide.  This left public health professionals – including myself – outraged.  Why can’t the appropriations for the Department of Defense be on the chopping block instead?

But now it all makes sense.  The dots are finally connecting because of that anecdote Dr. Austin shared.  One of the main reasons that the field public health has trouble getting traction with funding streams is that the greater public – whose health we ironically serve to improve – doesn’t really know what we do.  And when a member of Congress sees a significant budget devoted to what appeared to them as “translating language,” then our efforts will always be reactive in nature – why are you taking from our much needed annual appropriation?  Therefore we must strive to espouse one of the basic principles of public health: take action for a proactive solution to funding – “Dear members of Congress, this is why we need what we are asking for.”

Until we get to that point, we’re still downstream on that river asking why there are so many people falling in.

I know we can do better and I am confident that we will.

“Anybody can become angry – that is easy, but to be angry with the right person and to the right degree and at the right time and for the right purpose, and in the right way – that is not within everybody’s power and is not easy.” — Aristotle

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