Summary Report Discussion 30th July 2020
This event focused on reconfiguring health research to focus on non- pharmaceutical interventions, communication and transparency in translating scientific evidence into policy, addressing the values behind policymaking, and improving community as well as individual health through a healthier diet.
Panel:
Dr Shireen Kassam. Consultant Haematologist, Senior Lecturer at King’s College Hospital, and Visiting professor at the University of Winchester. Shireen is the founder of Plant-Based Health Professionals.
Dr Nisreen Alwan. Associate Professor in Public Health at the University of Southampton. Nisreen is a social influencer, expert on Nutritional Epidemiology and is a Fellow of the UK Faculty of Public Health.
Dr Jacob Stegenga. Reader in the Philosophy of Science at the University of Cambridge. Jacob is the author of Medical Nihilism and Care and Cure: An Introduction to the Philosophy of Medicine.
· Facilitator: Theo Richardson-Gool, Co-founder of Cov360
Non-pharmacological intervention research
Most current interventions are focused on pharmacological interventions funded by pharmaceuticals creating a bias in research (BMJ, 2019). However, Dr Jacob Stegenga noted that during the pandemic “arguably the most important kinds of things we can do are strictly non-medical… The pandemic has alerted us to how little we know about these kind of interventions”.
“The pandemic has alerted us to how little we know about these kind of interventions”.
Jacob believes a reconfiguration of the scientific research agenda is required to evaluate public health measures on for example: the effectiveness of different masks and the impact of international border closures. He argued that a centralised research institution, focused on pandemic-specific empirical research to inform predictive models and guide policy makers, is required.
Health inequalities
Nisreen highlighted how the environment and access to resources are barriers to individuals adopting healthy behaviours. She emphasised that behaviour change can only occur by addressing the wider socio-economic determinants of health. Regarding COVID-19, she discussed concerns about oversimplifying the link between COVID-19 and risk factors such as ethnic background. She stated risk factors “cluster together in certain population groups” and detailed how COVID-19 has exposed inequalities inherent across societies.
“Risk factors “cluster together in certain population groups” and detailed how COVID-19 has exposed inequalities inherent across societies.”
Nutrition
Nisreen referred to Food Foundation study (2018) which found that UK households in the lowest income deciles would need to spend 30% of their disposable income to meet the Eatwell Guidelines. Shireen stressed the components of a healthy diet as predominantly minimally processed plant foods, and how society has “moved so far away from that, with less than 30% of UK adults eating five portions of fruit and vegetables a day”. Shireen further highlighted the importance of a healthy diet to reduce chronic diseases and boost immune response and stated, “it is entrenched in our society that these unhealthy lifestyle behaviours are accessible and affordable more so than healthy behaviours”.
Limitations of scientific evidence
When scientific evidence is translated into policy, Jacob asserted that it is important to acknowledge the assumptions and limitations of models, and that these must be communicated transparently by policymakers. Nisreen cautioned against oversimplifying the science. Instead, the uncertainties underpinning the decisions made at a policy level must be relayed to the public.
“The uncertainties underpinning the decisions made at a policy level must be relayed to the public.”
Addressing values behind policymaking
Nisreen emphasised the need for policies that enable adherence to COVID-19 measures, such as statutory sick pay for quarantine. Jacob suggested that policy decision-making processes needed to reflect the difference in global and regional settings and this required interchangeable values. Shireen cited the UK government’s prioritisation of dairy and milk advertising in the midst of the pandemic as an illustration of non value-based policy.
Delivering urgent change through policy
Shireen emphasised the need for a “fit-for-purpose” food system and policy that benefits people and the environment. Both Nisreen and Shireen discussed subsidising fruits and vegetables as an example of policy change that would tackle systemic inequalities. Shireen believes policies need to focus on community-led behaviour change.
Jacob referenced Kitcher’s well-ordered science theory (2001), which considers an approach whereby scientific results are translated into policy to produce an ideal context of openness, transparency, and communication. He asserted that “If we continue like the status quo, it is guaranteed we will be facing pandemics in the future”.
By Michael Baser, Charlotte Bexson, Iman Hameed
Members of the Public Health Pathways team, and postgraduate students of Kings College London, Imperial College London, and London School of Hygiene and Tropical Medicine.
11 August 2020
You can watch the full event here:
