A Critique of O’Byrne’s Understanding of Ethnography and the Politics of Public Health Research

2018 ◽  
Vol 29 (5) ◽  
pp. 739-746 ◽  
Author(s):  
Julien Brisson

Patrick O’Byrne criticizes the use of ethnography in public health research focused on cultural groups. His main argument is that ethnography disciplines marginalized populations that do not respect the imperative of health. In this article, I argue that O’Byrne has an erroneous understanding of ethnography and the politics of scientific research. My main argument is that a methodology itself cannot discipline individuals. I argue that if data are used as a basis to develop problematic public health policies, the issue is the policies themselves and not the methodology used to collect the data. While O’Byrne discourages researchers from conducting health research like ethnography focused on cultural groups, I argue the exact opposite. This has to do with justice and equity for marginalized communities and the obligation to tailor health services for their specific needs, which may not be the same as those of the general population.

2020 ◽  
Author(s):  
Xiang Gao ◽  
Qunfeng Dong

Estimating the hospitalization risk for people with certain comorbidities infected by the SARS-CoV-2 virus is important for developing public health policies and guidance based on risk stratification. Traditional biostatistical methods require knowing both the number of infected people who were hospitalized and the number of infected people who were not hospitalized. However, the latter may be undercounted, as it is limited to only those who were tested for viral infection. In addition, comorbidity information for people not hospitalized may not always be readily available for traditional biostatistical analyses. To overcome these limitations, we developed a Bayesian approach that only requires the observed frequency of comorbidities in COVID-19 patients in hospitals and the prevalence of comorbidities in the general population. By applying our approach to two different large-scale datasets in the U.S., our results consistently indicated that cardiovascular diseases carried the highest hospitalization risk for COVID-19 patients, followed by diabetes, chronic respiratory disease, hypertension, and obesity, respectively.


1998 ◽  
Vol 1 (3) ◽  
pp. 23-26
Author(s):  
Don Brand

THE INDEPENDENT REFERENCE GROUP, set up to advise ministers on public health policies and service developments, has produced a summary of its findings. This paper presents the group's main views and priorities for action.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
◽  

Abstract About 90% of the biomedical data accessible to researchers was created in the last two years. These data have a very meaningful impact both in creating public policies on health, as well as public health research. This certainly implies complex technical problems on how to store, analyse and distribute data, but it also brings relevant epistemological issues. In this workshop we will present some of such problems and discuss how epistemic innovation is key in order to tackle ethical issues related to the use of big data in public health research. Databases implied in public health research are so huge that they rise relevant questions about how scientific method is applied, such as what counts as evidence of a hypothesis when data can not be directly apprehended by humans, how to distinguish correlation from causation, or in which cases the provider of a database can be considered co-author of a research paper. To consider such issues nowadays, current protocols do not hold, and we need innovation in methodological and epistemic procedures. At the same time, due to the fact that a relevant deal of such biomedical data is linked to individual people, and how medical data can be used to predict and transform human behavior, there are ethical questions difficult to solve as they imply new challenges. Some of them are related to communication issues, so patients and citizens understand these new ethical problems that didn't arise before the development of big data; others relate to the way in which public health researchers can and can't store, analyse and distribute information, and some others relate to the limits on which technologies are ethically, safe and which ones bring erosion of basic human rights. The four contributions in the workshop analyse these questions in some detail. During the workshop we will present a coherent understanding on what is epistemic innovation, some logical tools necessary for its development, and then we will discuss several cases on how epistemic innovation applies to different aspects of public health research, also commenting its relevance when tackling ethical problems that may arise. Key messages The workshop deepens the ethical and epistemological innovations involved in public health policies and research, specially related to big data. The workshop analyses novel aspects of public health ethics


Author(s):  
Haihong ZHANG

LANGUAGE NOTE | Document text in Chinese; abstract also in English.在中國,無論是對公共衞生內涵的理解還是公共衞生建設的相應理念等在很大程度上都存在因襲、甚至照搬西方模式的問題。在公共衞生責任主體的界定問題上,中國政府強調其對公共衞生的有限責任,認為公共衞生建設是需要政府、社會、團體和民眾的廣泛參與、共同努力的系統工程;學者們卻對政府提出了更高的期望。基於政府應當在公共衞生中承擔主要責任的立場,筆者強調各責任主體在公共衞生中的合作關係。相比於西方社會,中國缺少第三部門 (或非牟利團體) 的社會現實決定了我們必須找尋適合中國自己的出路。通過對傳統儒家家庭觀的批判繼承,筆者認為應當借鑒指導中國家庭的組織與建構,進一步重塑家庭在當代中國公共衞生中的角色。筆者希望借助家庭作為中國社會傳統資源的優勢,讓其在當代轉型社會中充當連接政府和個人的橋樑。一方面,筆者試圖從傳統儒家思想出發建構其理論基礎,另一方面,筆者亦希望該努力能為中國的公共衞生建設找到一條有效途徑,以期為構建中國自己的公共衞生找尋到一條現實而合理的出路。The SARS epidemic in China in 2003 highlighted the significant role played by public health in contemporary society. It also stimulated public health research in Chinese academia. Although the area is too complex to be concisely defined, it is widely recognized that public health focuses mainly on prevention, protection, and promotion. In China, we have usually attempted to copy Western models to deal with Chinese problems in general and public health issues in particular. A serious problem, however, is that such models may fit Chinese contexts well. Chinese scholars have engaged in Western theoretical debates without considering China’s unique conditions. I think that this is not an effective way to conduct public health research in China.China faces three major problems in public health services. First, different kinds of chronic diseases severely affect people’s everyday lives, and there is wide regional disparity in public health. Second, it is very difficult to carry out public health services in many regions in the absence of a decent nation-wide minimum healthcare system and a trust relationship between physicians and patients. Finally, because of the one-child policy, the Chinese population has become old before the nation becomes wealthy.It is impossible for the government alone to deal with all of these difficult problems. Although public participation has been suggested, little has been done to encourage it. It is high time that China adopted a suitable strategy that is based on its unique traditional resources. The family is the key to public health in China. For more than five thousand years, Chinese society has been family based. Although the structure and functions of the family have greatly changed in contemporary times, the resources of the family cannot be overlooked in addressing public health in China. Confucian ethics, which underlie contemporary Chinese society, stem from ideas of proper family life, relationships, and management. If we seriously consider certain public health areas, including health education, disease prevention, and health promotion, then the role of the family is inevitably highlighted. The various elements of Confucianism, such as human flourishing, harmonious family life, filial duty, and mutual respect among family members, constitute the ethical guidelines for the construction of a theory of Chinese public health services and the practical application of such a theory. In addition, compared with Western countries, China still has a long way to go regarding third parties or nongovernmental organizations (NGOs) contributing to public health work. Perhaps family-based associations, such as traditional family clans, will be able to act as Confucianist NGOs and play a significant role in promoting Chinese public health.DOWNLOAD HISTORY | This article has been downloaded 642 times in Digital Commons before migrating into this platform.


2021 ◽  
Vol 31 (Supplement_3) ◽  
Author(s):  
◽  

Abstract   The term public health is well known. However, there are many meanings and competing ideas about what public health practice, public health policies and public health services are, should be or could be. There are different understandings of public health's main concepts (e.g., health protection and health promotion), diverse underlying basic normative assumptions (e.g., regarding paternalism or justice), and competing views on how public health policies should be developed (e.g., through top down or deliberative/participatory approaches). Different theories and ideologies frame the debate. They refer to the value of privacy and spheres of personal decision-making, the image of human beings as social or political animals, and the role of the liberal-democratic state. Those theories also reflect different historical developments and institutionalized experiences underlying differences in “political cultures” and related understandings of “public”, and consequently, of “public health”. However, we as a “public health community” do not often reflect on the different understandings of “public” in “public health”. E.g., what is the meaning of “public” and what is “public” about public health services? The need to make and evaluate COVID-19 public health policies and practices underlines the necessity for an ongoing reflection to identify good answers. Against this background, the workshop addresses the following questions: What different kinds of understanding of key concepts of “public health” - including the concept of “public” itself - underlie different kinds of interventions, measures and policies to tackle the ongoing public health emergency / the Covid 19 pandemic? What are the ethical lessons from the pandemic and implications for public health policies and activities? The roundtable workshop will start with a key contribution by John Coggon (Chair in Law and Director of Centre for law and Society, University of Bristol), reflecting some core messages of his seminal book “What Makes Health Public?” and recent research on the issue in the light of COVID-19-policies. Together with three further panelists key messages and reflections will be discussed from the different disciplines of political science, ethics, social science and policy / practitioner perspectives, drawing out implications for policy, research and practice. This will be followed by reflections and discussion with the workshop participants and their reflections and insights on these critical questions. Speakers/Panelists John Coggon University of Bristol, Bristol, UK Kai Michelsen Fulda University of Applied Sciences, Fulda, Germany Peter Schröder-Bäck University of Applied Sciences for Police and Public Administration in North Rhine-Westphalia, Aachen, Germany Sadie Regmi Public Health Registrar, University College London, London, UK Key messages In theory, different conceptions of the normativity of the key term “public” lay different foundations for the role of the state and the scope of the policies initialised to advance PH aims. In practice, PH policies are strongly driven by political and economic interests of “the ruling classes”, but modified by civil society and institutionalised historical experiences.


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