Written by Aela O’Flynn, MBBCh BAO candidate, University College Dublin, Ireland and participant in the 2021 Institute for Public Health Summer Research Program
Equality is a key goal of healthcare – equal access, equal treatment, equal care. The reality is complicated, however, and the social determinants of health demand a more nuanced solution. Instead, we must strive for equity in health.
According to the World Health Organization, health equity is defined as “the absence of unfair and avoidable or remediable differences in health among population groups defined socially, economically, demographically or geographically”. How can we incorporate health equity into research? This was the topic of a fascinating workshop as part of the IPH Summer Research Program, Public and Global Health Track with Angela Brown, MD, vice chair of Health Equity and professor of Medicine in Cardiology in the Department of Medicine at WashU.
Dr. Brown proposes that health equity requires community engagement in research. Community-engaged research is “the process of working collaboratively with groups of people affiliated by geographic proximity, special interests, or similar situations with respect to issues affecting their well-being” (Centers for Disease Control and Prevention). It applies to all research, at all times, and should be incorporated from the earliest stages of a project.
Dr. Brown describes three main steps to practice community-engaged research. Step 1 identifies all parties with interest in the research and its potential outcomes. Step 2, the crux of community engagement, is to develop meaningful relationship with identified stakeholders. Like any relationship, this requires time, trust and total transparency. Step 3 is long-term commitment to this community. Breezing in and out in a whirlwind of grants and data collection does not best serve the community. A meaningful relationship with mutual respect and contribution, meanwhile, can have a profound and long-lasting impact that benefits both parties.
Community engagement should be at the core of any project. It can, and should, inform the direction of research to have most impact on the communities involved. While we may assume that a certain project is of most benefit to a community, their view on their priorities and needs may be completely different to what we might have imagined. We must not underestimate the value of the lived experience of individuals at the heart of the problems we hope to solve.
I always understood the urgent need for health equity, both on a local and global scale. It has been all too easy, however, to assume that I could not possibly have a meaningful impact at such an early stage of my career. This could not be further from the truth. As a young researcher and medical student, I have a unique opportunity to strive for community engagement in both research and clinical spheres to contribute to health equity in my own areas of study and training. While I now feel the weight of that responsibility, it is a challenge we all must meet.