Does social science need rebranding?

Some would argue poor living conditions and gender inequity affect health more than the biological causes of disease. Flickr/LivingWaterInternational

As Forum 2009 closed on Friday, we were left with some thoughts on the future direction of global health research. The conference in general was heavily weighted towards the need to drive health systems research and research on the social determinants of health.

Mention these issues to many lab scientists, however, and they would argue that these fields of study are far too “soft” a science for them to engage with.

This is what really damages research into the social factors affecting health. Traditional robust methods of interrogating an issue and gathering data such as randomised controlled trials have no traction when you are thinking about how a health system functions or when you are trying to evaluate a complex health intervention.

These don’t fit into neat scientific boxes in the way that parasite counts or viral loads do.

But transforming these fields will require rigorous evidence – how else will we know what changes to make to improve health systems across the developing world?

It’s good news then that the EU announced yesterday at the meeting that its next call for grants in January 2010 would focus heavily on research into the social determinants of health.

Some would argue that poor living conditions and gender inequity affect health even more than the biological causes of disease. There is only one way to find out, of course: more research, and more robust evaluation of that research.

Priya Shetty, www.scidev.net, priya4876@gmail.com

Global health’s ′Cinderella′

Described as the ″Cinderella″ of global health by chair Richard Horton, editor-in-chief of The Lancet, the session on non-communicable diseases (NCD) certainly shared the topic’s luck.

Technical problems struck first when a video from Ala Alwan, WHO assistant director-general of non-communicable diseases and mental health, on ″After Bamako: Taking the agenda forward″ was unable to be played.

Noise from a couple of rooms off the back of the hall where the session was being held also plagued the talk, although the sharp questions that were asked during Q&A showed that the audience hadn’t allowed that to distract their attention from the speakers.

Horton also pointed out that ″if NCD is Cinderella, mental health is the ugly stepsister″; for while WHO has recently developed a programme for tackling NCDs, mental health is still not being given the attention it deserves. Especially when depression is among the top three causes of disability around the world.

One of the speakers, Sania Nisthar, president of non-governmental agency Heartfile, Pakistan, also brought up the interesting situation where researching NCDs in her country has indirectly led to the improvement of the health information system.

For example, morbidity surveys are based on assessment of risk factors rather than actual cause of death as overlapping diseases make it difficult to accurately define the cause of death.

Data on these risk factors are integrated into general demographic surveys due to resource constraints. Researchers using this data have discovered gaps in the data collection, which has resulted in them reviewing and refining the methods of national health data collection in order to facilitate their own research into NCDs, thus improving the health information system.

Shiow Chin Tan, SciDev.Net