Strong SDHI representation at the American Public Health Association Annual Meeting and Expo in Boston

Like in the previous year, SDHI affiliated researchers had a substantial presence at this years largest academic and professional public health conference with an estimated 13000 delegates. SDHI Associate Director Professor Peter Donnelly (St Andrews) hosted a special session on the recent Sandy Hook School Shooting in Boston, which brought together different perspectives ranging from parents, criminologists to policy makers.

Damien Williams presented posters on the relationship between community and domestic violence and football matches in Glasgow as well as on alcohol use quantities and patterns among university students at St Andrews.  Thilo Kroll contributed to a special session organised by the Disability Chairs Forum of the APHA Disability Section on ‘The a Construction of Disability and Health: The Role of Spaces and Places’, a discussion which continues on Facebook, and to a presentation entitled ‘Addressing the psychosocial support needs of cancer co-survivors in low income communities’ as part of a session on ‘Social Determinants of Behavioral Health: Addressing Root Causes through Public Policy and Community Practice’ . The latter also introduced SDHI’s sister platform, FRED (family focused research, education and development), which aims to bring together researchers, practitioners and families globally to examine and tackle social deprivation and marginalisation issues related to health. At present researchers from the Unites States, Finland and the UK are engaged in this effort. Thilo also presented three posters relating to a recently completed study on outcome measurement after stroke. The posters focused on rehabilitation professionals’ attitudes to outcome measure use, rationale for selecting outcome measures, and engagement of stroke survivors with aphasia in the discussion about what matters after stroke.  Shiraz Sheriff, PhD student who is supported by SDHI team directors Ed Hall and Thilo Kroll presented his poster, entitled ‘Asthma, deprivation and the urban environment in Scotland: Evidences, challenges and directions‘. For the first time SDHI was also involved in the APHA Film Festival where Lisa Nicoll’s film ‘Wasteland’ was shown. A productive evening session with PhD students has further linked SDHI’s research portfolio and support for postgraduate researchers to a wider international group, which is part of the internationalisation ambitions of SDHI. The presence of SDHI at APHA was particularly poignant this year as the motto of the conference was ‘Think global, act local: Best practices around the world’.

‘Dismantling the fence’ Day 3 @APHA

On the first day of the conference I reflected on the contrast between the life on the streets of San Francisco and the ‘protected’ and sealed off environment of the conference (how many homeless people got to attend and have a say?). Both so close and perhaps, even connected in content and practice but at the same time worlds apart. This impression stayed with me throughout my days here and was reinforced on the walk from and back to the hotel where a very heteregoneous community of the dispossessed desperately push for some visibility in this world of shiny displays of upmarket jewellery and fashion stores. They are kept outside in the doorways, park benches, gutters and may only find temporary access to the indoor world in a subway, parking garage or overnight shelter. They are shunned, made different, a line is drawn between them and us. Perhaps, the accelerated step when rushing past them, the averted glance, the raised voice to silence their request for a bit of hope in the form of money – perhaps, all this is just our way of maintaining the divide between them and us so that we do not have to confront the reality that they at one point also played a role on our side of the fence. And that our life path could catapult us very quickly into ‘their world’. Now why am I writing this? The point is that we are taking this dividing line into our research. Most public health or other health-related research is still ABOUT people and populations. It is not conducted WITH people who are the immediate stakeholders. Participants in studies are still relegated to being ‘subjects’ in academically pre-conceived studies that seek to fill a gap in the segregated world of evidence-based practice. The number of truly emancipatory and participatory action research projects is ridiculously small. And this approach is frowned upon by many traditional empiricists and frequently rejected as unscientific as the population, the intended outcomes, and the intervention processes may change in the context of the study. BUT, this type of ‘research’ produces immediate change that is driven by the community as the principal stakeholder. It is a research WITH, not ABOUT. To be fair there may have been brilliant examples – and I know there indeed have been – of this way of working at the APHA conference but I would still maintain that very few community representatives could afford participation at the conference. We need more ‘WITH’ in our applied health and social research. There is so much to gain: greater ecological and external validity, buy-in and support of the research from Day 1, more rapid change, fulfilment of human rights on inclusion and the dismantling of the socially constructed fence between ‘them’ and ‘us’.

Growing recognition of SDHI in the APHA Disability Section

It is day 3 of the APHA Public Health Conference in San Francisco. While some of the presentations and sessions have suffered from a lack of attendance due to storm Sandy and possibly from a slight innovation fatigue the day has brought lots of interesting conversations and opportunities for disability, rehabilitation and health research. Just a few previews of what may develop into further collaborations: a Fullbright scholar exchange with SDHI that would allow us to deepen understanding of global disability measurement issues. Another positive development is that we will shortly announce additional webinars with academics from Cornell University and the University of Kansas. Further, there has been an interest from various parties in another conference on participation and disability, similar to the conference that we hosted in 2011. There are also concrete ideas to advance collaboration on research projects in the areas of physical activity and disability and disability measurement. Finally, steps have been taken to invigorate the online journal ‘Rehabilitation Process and Outcome’ with several manuscripts planned for submission. This very personal reflection does not capture the various experiences that other SDHI affiliated researchers have made. I will seek to capture some of those over the next few days as well. Next year’s APHA meeting will be held in Boston. It is entitled ‘Think global, act local’ and it will be a wonderful opportunity to showcase the spectrum of social dimensions research that is happening at the universities of Dundee and St Andrews. Sunny greetings from California!

SDHI @ APHA Day 2 Reflections 

Storm Sandy that has approached the East coast of the USA has disrupted air travel for a lot of delegates, some returned home after just a day in San Francisco. An interesting day nevertheless. The afternoon just concluded with a focus group on conference accessibility to which I was invited. APHA wants to be a leader in this area but still has a long way to go. As one conference delegate this afternoon told me, his personal assistant was denied access to the meeting exposition hall as he did not have a badge identifying him as a paid participant nor as a personal assistant. This is just one example that accessibility and assistance are not universally available to people with disabilities. It is still an erroneous and rights violating assumption that accessibility only needs to be an issue or concern for the disability section. What about the visually impaired epidemiologist who presents his work in the infectious disease section? What about the mobility impaired nurse who workes in community based health promotion? What about the statistician with cerebral palsy who relies on communication aids to convey findings of the latest national health statistics on obesity? You may get my point. I am not only talking about APHA but about practices in the UK and Scotland, in Higher Education as well as in the NHS. I am talking about the human right of full inclusion of people with disabilities in all areas of life, including academic conferences.

As for the content of the presentations in the Disability Section I cannot hide a certain degree of frustration as I see little progress over the years. We don’t seem to manage to move away from documenting the barriers and problems that people with disabilities face in health care and employment. Where are the innovative programmes? The best practices? Where are the evaluation research studies the knowledge transfer projects? 
Occasionally, we see presentations that position disability within a broader context, within the global challenges that affect all human beings: environmental changes and barriers, technological developments, an ageing demographic, the effect of economic marginalization. But so far I have not seen any presentation at this meeting that has tackled any of these issues. Also, we clearly focus most research on physical disabilities. Where are the people with learning disabilities or intellectual disabilities? Where is speech-impairment related research? Where is the presentation that explores health care issues for people with complex disabilities? Are we missing the point? 
The Social Dimensions of Health Institute benefits from its many diverse perspectives, disciplines and skills set and I can see how a social dimensions perspective is essential for an innovative focus in our understanding of disability and public health issues. 
A joint challenge for APHA, the Disability Section and SDHI is to move towards more participatory research and practices. 

SDHI @ APHA San Francisco Impressions

Maybe, it is the jetlag but as the first full conference day in San Francisco winds down I cannot help but think of the huge contradictions, the contrast between aspiration and living that I have seen after just a few hours in town. The largest gathering of public health professionals in the world with an expected 13,000 delegates with their shiny name badges on the one side, who are well shielded inside an enormous convention centre and multiple satellite hotels, well meaning and effortful; and the streets around Union Square and Market Street with all the glittering high end brand names with countless nameless people scattered in front of them who desperately clutch the paper cup that rattles with a few dimes and perhaps even quarters, not seeming to know what the next day will bring. Ingeniously, one street musician used empty plastic buckets and bottles to create something unique and captivating in the absence of ‘standard instruments’ while just a couple of blocks away a busy Jazz restaurant attracts a more affluent crowd, Memorable to me, the young man in his standard issue wheelchair, too unwieldy and large to be practical and a far cry from modern sports wheelchairs, who sought shelter in an entrance way to a shop. The number of blankets around him suggested that he would spend the night there. 

A country so large, so affluent still arguing about the benefits of universal health care coverage, with the highest health care expenditures in the world and with poorer health outcomes than far less wealthier nations. The presential election is less than a couple of weeks away. But who will vote? Who will make use of the vote?
This afternoon at the poster session, where the employment experiences after cancer study (Wells et al.) – which had involved several SDHI team members – was presented a lot of the discussion focussed on how employers can make adjustments in the workplace, especially when they perceive fundamental economic pressures themselves. 
More impressions from the sessions tomorrow, including Twitter.
Oh, and for the record, the San Francisco Giants have just won the World Series title beating the Detroit Tigers. 

SDHI at the American Public Health Association (APHA) Annual Conference and Expo in San Francisco

Several SDHI researchers from Dundee and St Andrews will be heading to San Franciso shortly to present research findings at this year’s Annual Meeting and Expo of the American Public Health Association. It is the largest global gathering of public health experts, researchers, practitioners and advocates with an expected 13,000 delegates. It is not only a fantastic opportunity to showcase state-of-the science research but also a venue for networking and development of research collaborations. ;

SDHI will be reporting from the event via Twitter using #APHA and #SDHIAPHA and on this blog. So, stay tuned for more.