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Public health research - multidisciplinary, high-benefit, undervalued

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Public health research - multidisciplinary, high-benefit, undervalued
Mark McCarthy*

Department of Epidemiology and Public Health, University College London, 1-19 Torrington
Place, London WC1E 6BT, UK
(Received December 2009; final version received March 2010)

The major health problems faced by policy-makers and practitioners at national and local levels require public health approaches. However, public health research is the ‘‘poor relative’’ of biomedical research: it is worthy, but not rich. In the European Commission’s health research programme, biomedicine gets 90% of the funding, whereas public health research gets less than 10%. This pattern is repeated nationally in most countries, reflecting public policies to support
industries pharmaceuticals, biotechnology, medical devices where profits are to be made, rather than not-for-profit, public health research. SPHERE, a study coordinated through the European Public Health Association, conducted bibliometric analyses across public health research themes and mapped the European and national structures and priorities for research. Whilst most European countries have national strategies (and some programmes) for public
health, few have public health research strategies and the coordination of public health research is weak. Three further studies are being undertaken. In STEPS, the contribution of civil society organizations in the new EU member states to public health research will be discussed at national workshops with the ministries of health, the science/research councils and the national public health associations. In PHIRE, thematic Sections and the national member associations
together evaluate the impact of European-funded health projects within member states. In FAHRE, the specific theme of food and health will be addressed, bridging industry and non-profit research sectors. Arguments for public health research can be made through lobbying at European level, but researchers and practitioners also need to influence the development of public health research within individual countries leading to a European Public Health Research Area.
Keywords: public health; research; Europe; evidence; finance; publications

Why public health research for Europe?
Our contemporary health problems require public health approaches as well as medical treatments. In providing care and support for sick and disabled people, health services are more concerned with the management of disease after its onset than with its prior prevention or minimization. It has been estimated that in recent decades population health has improved by around one-quarter as a direct result of medical treatments, whereas improvements in public health - organizational, social and environmental - have contributed most of the increase in life expectancy (Mackenbach 1996, Bunker et al. 1994). Yet, while we know that new public
health interventions are needed to control the main causes of disease and disability - including heart disease, cancer and mental illness as well as accidents - and to improve the organization, effectiveness and efficiency of health services, we are much less sure which, and how, interventions work.

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