Opinion: 29 September 2015.
This article was originally published on Croakey.
One of Australia’s foremost researchers in immunisation behaviour Julie Leask was recently presented with a Research Action Award by the Sax Institute for work ‘that has changed the way we design and deliver health care’.
It was a rare recognition of the quiet achievements of public health, she writes.
Last week, I was among four researchers given an inaugural Research Action Award from the Sax Institute. The award recognises research that’s had an impact on health policy, programs or service delivery.
It was a great evening, where we celebrated with colleagues from the research and policy communities and enjoyed the opportunity to see public health and health services research spend some time in the spotlight.
Spotlight isn’t a word often used around this type of research. Scan down the awards lists for grant schemes and scholarships and you’ll find many opportunities for biomedical and science researchers. But public health research seems to fall through the gaps.
Perhaps it’s because public health and health services research is not quite as tangible. When I was based at National Centre for Research and Surveillance (NCIRS), a TV news crew would come out to interview colleagues about the latest vaccination issue. They would arrive, scan a large open office of desks and computers and ask to go to the unrelated labs upstairs to film them with a microscope backdrop. The crews understandably sought a visual ‘sciency’ look that symbolised vaccination. Yet NCIRS staff were dealing with evidence acquired well after the lab work was complete.
All research is critically important – biomedical, clinical and public health. Australia has world class researchers studying disease pathogenesis, developing new or better drugs, and trailing them. But the ‘bench to bedside’ doesn’t stop there. A whole arm of research studies patterns of disease in populations, the antecedents of health problems, prevention behaviours. They develop and evaluate complex interventions, study cost effectiveness, and ask how health programs and policies can be fair, just and equitable.
Immunisation is a perfect example of how biomedical research and public health research are interdependent. We undoubtedly need vaccines that are effective and safe. But we also need the public health researchers who do the disease surveillance, the epidemiology, the systematic reviews, and economic studies that tell us whether a vaccine should be recommended.
Safe and effective vaccines are of no use if the public will not take them. I work with others on the behavioural aspects of vaccination, looking at what helps and hinders vaccination uptake and good process. One key message is that strategies to improve childhood vaccination acceptance should target fence-sitting parents rather than those who have entrenched opposition to immunisation. Also, uptake of vaccines for all people – children and adults – requires well-oiled systems, good record keeping, support for those administering vaccines and good communication.
Professor Nicholas Mays, from the London School of Hygiene and Tropical Medicine chaired the awards assessment panel and at the Awards event last week he emphasised the importance of seizing opportunities. So I want to put the spotlight on what many others in public health do quietly behind the scenes. Public health research almost always requires teams. Fellow awardee, Farah Magrabi summed it up, “I work with a team of great people as all good projects. And this award is really as much theirs as much as it is mine.”
Indeed, in public health research there are usually some very quiet achievers to whom we owe so much and who rarely receive public acknowledgement.
I have already mentioned NCIRS. Their policy support section for example, are a small team of quiet achievers, work with incredible dedication, commitment to accuracy and objectivity, spending long hours in bringing together the Australian Immunisation Handbook and advice for the Australian Technical Advisory Group on Immunisation and other bodies. These quiet achievers help make vaccine programs safe, effective, and efficient, and we so heavily, yet unknowingly, rely on their work.
Another group of researchers from an NHMRC Centre of Research Excellence study immunisation in under-studied and special-risk groups, helping to understand the immunisation needs of Aboriginal and Torres Strait Islander peoples, migrants and refugees, the frail elderly and neonates and parents.
For some years I have been collaborating with the Tamworth office of Hunter New England Population Health. There is a strong commitment to Aboriginal health, working with the community, listening, enabling, employing Aboriginal staff, and making a difference. Staff in the LHD more broadly were successful in closing the immunisation coverage gap in 12 month old babies through a program where Aboriginal staff send a text message reminder before a baby’s vaccine is due.
At the awards night, it was fascinating to see how the other award winners had each taken a different path to getting their research used in practice: my University of Sydney colleague Dr Anne Cust for her pivotal work that led to sunbeds being banned in several Australian states; Dr Santosh Khanal from the NSW Ministry of Health for his research on removing barriers to delivering a childhood obesity program; and Associate Professor Farah Magrabi from Macquarie University for her world-leading work on tracking IT-related patient harm.
We are all driven by a desire to see research that could have been locked behind publisher paywalls or left to gather dust on library shelves shared with people who have the capacity to improve health programs and services. And it’s just as exciting to see it recognised publicly.
I hope this is the beginning of more recognition for public health and health services research and the central place it has in supporting quality population health programs and healthcare in Australia.