John Ruffin, former head of the National Institute of Minority Health and Health Disparities wrote:
"The 19th-century scientist and pathologist Rudolph Virchow gave voice to many of our present-day concerns about disparities and went a long way toward defining the task before us. A socially minded man, he believed that science should speak the language of the common people and that medicine should serve the public's health. He wrote, 'If medicine is to fulfill her greatest task, then she must enter the political and social life…'"
Do you agree and why? Is it permissible for scientists to become advocates in the areas of their research? What steps can one take to balance advocacy with the objectivity that is considered the ideal in scientific inquiry?
I do agree with the above statement. The goal of medicine is to improve health and alleviate suffering of all people. Despite the what we are primarily taught in medical school, this cannot all be done from a lab bench, hospital ward, or clinic. I think it is permissible, and necessary for scientists and clinicians to become advocates in their area of research. That being said, this must be done with great caution and tact. Just as it takes specialized skills to treat advanced heart failure, perform procedures or surgery, and design basic science experiments, I believe it takes specialized skills to appropriately and effectively integrate medicine into political and social life. I think an important step in bridging this gap is to provide appropriate specialized training and to build transdisciplinary teams to address controversial issues.
Please describe an of controversy for health disparities research that you learned about in this course, or alternatively an area of research that should be prioritized in health disparities. Include why you find this area interesting or controversial.
One are that we discussed this quarter that I find particularly interesting is disparity-related measurement and the metrics we use to perform and understand research. I think many researchers (myself included) use variables to capture social determinates of health without a clear understanding of the background, implications, or even of how they are collected/obtained. I have learned how critical it is to be thoughtful of the way that we use these variables (ie race, ethnicity, education, income, etc) in research that is both focused, and not focused, on health disparities. By using variables without understanding their implications we can draw inaccurate or flawed results. Equally important, and controversial, is the way that we “control” for these variables. How many times have researchers “controlled” for race/ethnicity without giving thought behind why, or what this adjustment is saying in their results/interpretations? I think researchers need to be more thoughtful about this process and clear in explaining the details of these analysis choices and the rationale behind them.