Pregnancy science communication

Public Health science communication has for the past years been my field of interest. I have studied it, I have taught it, I have networked over it. But have I actually been a user of it – like I was before I started studying it? Well, over the past nine months I actually have. At least one particular field within public health communication has had my special attention. Not for the sake of how it is communicated, but the actually public health knowledge. The field relates to pregnancy, which coincidentally for the past nine months (and still is as I write these words) have been a part of my life.

A circus of information

When you become pregnant not only do a lot of questions pop up in your head, but a lot of information relating to the health and wellbeing of yourself and the baby is communicated to you, whether you like it or not. Doctors, midwives, health authorities, friends, relatives – all have information to share with you. It can be quite a circus of information and you quickly discover that the science of pregnancy is full of science AND of urban legends, gossip, personal narratives and experiences, and culturally imbedded practices. The later become especially obvious when you as I choose to have a child with someone from a different country than your own and go through your pregnancy in neither’s of yours home countries.

To do or not to do?

As a public health professional I have of course been interested in doing what is best for the baby, and with an academic background I lean towards following advice which is based on scientific research rather than word of mouth or traditional practices in the country I happen to be. I quickly realised however that the two often get mixed up. Even in official guidance and pamphlets are you sometimes left to wonder what the advice is based on. In the wine country Spain for example you can drink alcohol (in moderation that is) while in Denmark your are advised not to. As my iron level dropped my German doctor advised me to start taking iron tablets and continue throughout the entire pregnancy. My midwife has, for reasons I have yet to understand, advised me to stop some weeks before my due date. The argumentation for all these different recommendations is very often: “It’s better for the baby”. But says who? Based on what? What is the evidence? All theses questions arise all the time and it seems like way to big a task to investigate the scientific background behind all of them. I was therefore happy to learn that I didn’t have to! Thus, my cousin told me about this book she had read a review of, which basically did what I felt like doing with every piece of advice and recommendation I was presented with: Learn about the basis or science behind the recommendation and based on that make my own decision on what to do and how to act.

Expecting better

Expecting-Better-Why-the-ConEmily Oster, an associate professor of economics, decided, upon becoming pregnant, to test the facts of medical advice she was given by using the methodologies she knew best: an economist’s tools. The outcome of her struggles not only resulted in her making informed decisions right for her and her husband but also in the book “Expecting Better – why the conventional pregnancy wisdom is wrong and what you really need to know”. I have with joy been reading this book. Both for the content, but as I was reading it I realised also for its public health science communication value. Emily Oster manages to explain medical research without oversimplifying it and in a manner that most people without a health (or economist) background can understand. For a public health savvy person it is perhaps sometimes a bit too pedagogical and one can quickly become tired of having explained what a cross control study and a randomised trial is, but as public health professionals are not necessarily the target audience of this book this it not necessarily a bad thing. In addition, if one uses the book as a tool for looking up specific topics rather than reading it from A to Z the repetition is of course fine.

Facts and personal decision-making

One of the reasons I find the book to be an interesting example of public health science communication is that it manages to find a good balance between communicating scientific studies, findings and facts and at the same show how these can be used for decision-making – or in some cases are super difficult to drawn conclusions from and thus challenging to make decision upon. By sharing her own reflections and ultimate decisions with the reader, Emily Oster exemplifies that scientific findings and statistics take on a new meaning when they are to be applied to an individual person. Indirectly, it also illustrates how difficult it can be to make general recommendations when science doesn’t give clearcut answers (which is very often the case in public health research). Granted, at times you do become a bit tired of hearing about Penelope (Emily Oster’s daughter), but at the same time the book really wouldn’t have the same communicative value without it. Putting a human face and a name on science just makes it more relevant to read – at least when you are targeting a wider audience. And as mentioned it illustrates what happens to science when it moves from the laboratory, the statistical programme, the conference presentation etc. and meets real people.

Other reviews

“Expecting Better” was reviewed by Zoe Williams im the Guardian. I find her review of the book to be spot on, so instead of making more comments on the book, I’ll let you read her reflections, praise and critic.


Conference on Communication, Medicine and Ethics (COMET) in Switzerland

As member of the European Public Health Association (EUPHA) I receive a monthly newsletter with relevant Public Health news from the region. I have previously criticized EUPHA for their lack of focus on public health communication (see blog post “European Public Health Association and the missing communication category”).

Eupha

I maintain my critic, but must also congratulate them when public health communication does sneak its way into for example their newsletter.

Thus, in the January 2014 newsletter under Upcoming Courses and Conferences attention is made to the Conference on Communication, Medicine and Ethics (COMET), which will take place in Lugano, Switzerland 26-28 June 2014. The conference aims to bring together communication researchers from different disciplinary backgrounds, ranging from healthcare specialities to the human and social sciences.

The first Conference on Communication, Medicine and Ethics (COMET) was hosted by the Health Communication Research Centre at Cardiff University, UK in 2003 and was attended by more than 200 participants from 20 countries. Based on its success COMET has now established itself as an annual interdisciplinary, international event.

COMET is described as using a problem-oriented approach, and places special emphasis on the dissemination of high quality research in interpersonal, mass communication, and practical ethics which is directly relevant to healthcare practitioners.

The 2014 conference will focus especially on the dissemination of ongoing research in Doctor-Patient communication studies, health communication in the media, as well as practical ethics which engages directly with healthcare practitioners. Looking at the list of proposed topics and keynote speakers, it does seem like especially the doctor-patient communication will be given much attention, but I’m happy to note that themes like “Communicating Risk and Uncertainty”; ” Interprofessional Communication and Hospital Management Systems” and “Media and Health Communication” also figures on the list.

Assessing myself unlikely to attend, I do hope that the conference will set up a hashtag for Twitter and encourage social media activity during the conference, so that a broad audience (including me) can be reached.

The organisers of the conference accepted proposals for either panels or paper presentations (oral or poster) within the main themes up until 31st January 2014, so unfortunately the deadline has been passed, but I look forward to seeing the complete programme once it becomes available.


Public health science communication – an 8th goal for public health training in the 21st century

European journal of public healthIn the latest issue of the European Journal of Public Health, a wish list for what public health training should look like in the 21st century is giving by Martin McKee, Professor of European Public Health at the London School of Hygiene and Tropical Medicine: Seven goals for public health training in the 21st century

Having a bachelor and masters degree in public health sciences from University of Copenhagen, I know for a fact that at least in a Danish context public health science communication has not been part of the curriculum for public health students in the later part of the 20th or the first part of the 21st century. None the less, when I saw the headline of Martin McKee’s article, I was hoping that science communication would be an ambition for modern public health training.

Martin McKee article2

Unfortunately, I was to be a bit disappointed. The article starts out well, stating the need to “prepare people to engage actively in a complex and changing world in ways that improve the health of the population”. So how do you prepare people to engage actively in ways that improves their health? Well, in my world that will require that you as a public health professional and public health scholar can actually communicate what you are doing, what your theories are and what findings come out of your hard work. And that you can engage into conversation and discussion with the public and subgroups of the public (e.g. policy makers, researchers in other fields). In short, that you can communicate public health sciences.

Public health science communication is not mentioned directly as one of the 7 goals. In short that goals Martin McKee lists are:

  1. Stimulate curiosity
  2. Encourage social entrepreneurs who are willing to take the initiative
  3. Make epidemiological connections and understand the biological mechanisms behind
  4. Convey the big picture, expanding Koch’s postulates or Bradford Hill’s criteria of causality with mathematical models to provide evidence of links
  5. Make public health students literate about what (and who) they are up against
  6. Engage with key decision makers at all levels and be confident to speak up.
  7. Ground human rights into public health approaches

For all seven goals, science communication plays a key role, but is only partly mentioned under goal 6, articulating the need for public health people to be confident to speak up and share their knowledge. The only other time communication is touched upon is as an encouragement for public health professionals to not just stay updated on public health news but go beyond the scientific literature:

More than ever, the public health professional needs to read the Economist, the Financial Times and the Wall Street Journal.”

No suggestion is however broad forward about also contributing and communicating public health through these channels. Shouldn’t public health people aim to let their voice, knowledge and opinions be heard outside the ‘traditional’ public health media?

Another element missing in Martin McKee’s list is the IT reality of the 21st century and how Web2.0 already have and is still changing public health research and practice. He mentions the need for public health people to acquire a great deal more self-confidence and points out how:

with a fast internet connection, most students could do a much better job of understanding the topics they [politicians and social commentators] addressed”.

But the potential for new ways of communicating and engaging with the public broad forward by social media and other technologies is not mentioned at all.

Make public health science communication the 8th goal

Communication is almost a precondition for all other 7 goals, which is why I would argue that it deserves to be a goal in itself. Public health students should be given competences in communicating what they do, why they do it and taught how communication can benefit not only the people they are trying to help but also their own work (which then again will come to the benefit of the public). Public health is, as Martin McKee opens the article, not just a collection of different disciplines or the goals it seeks to attain. It is much more. Exactly this ‘much more’ however requires communication. Public health science cannot (meaningfully) exist in its own little universe. It only comes to life when it steps out of the public health sphere and meets the rest of the world. This, however, requires that we as public health people are dressed to meet the world and to communicate with it. Let’s make public health science communication skills the 8th goal of public health training in the 21st century.

The article by Martin McKee is unfortunately hidden behind a pay wall, but you can read an extract here: Seven goals for public health training in the 21st century.