Moving the needle on global health equity: a look back from 2030

The timing cannot be better for us to critically reflect about how our scholarly efforts can impact the world we want to see in 2030. It is only by taking the time to pause that we may begin to be able to exchange important thoughts about complex issues –social justice, systemic racism and structural inequalities–and their impact on our progress toward reducing health inequities in both the global North and the global South. Why “looking back from 2030?” It coincides with the United Nations Sustainable Development Goals (SDGs), a call for action by all countries, poor, rich and middle-income, to eradicate poverty and achieve sustainable development by 2030. To achieve these goals, we must reimagine where we want to be, so that our actions now can lead to vital change in the future.

I am delighted to serve as the Deputy Editor-in-Chief for our journal. I am presently an Associate Professor at the Ohio State University (OSU) School of Health & Rehabilitation Sciences in the College of Medicine, and affiliated faculty in the Universidad Peruana Cayetano Heredia School of Medicine. With a background in Industrial and Systems Engineering, I have been engaged in global public health research for the past twenty years. Born and raised in the outskirts of Lima, the capital of Peru, I have witnessed and experienced the impact of urban poverty among communities who live and work, only aspiring to have a decent quality of life.

In the midst of unprecedented global challenges and as we get closer to a meaningful, mid-point evaluation of the ambitious 2015–2030 Sustainable Development Goals plan, I would like to share a deeply personal reflection. The pandemic has offered me with a real opportunity to pause to give thanks, assess the impact of our scholarly work and reconsider my professional goals. I have asked myself over and over about what my role as an academic researcher should be, and my responsibility to engage with our communities in social justice learning and action. How well am I using the privilege of being a first-generation Hispanic college student, Ph.D. in Engineering, and woman of color in the United States? I have had time to reflect and consider the legacy I want to leave. I have examined how far I have gone and where I want to be, all from a different lens, an equity lens. I ask myself – and invite our international readers to consider the following questions:

• How do we disrupt traditional, rigid academic systems to make research environments more diverse and inclusive, locally and globally?

• In what ways are our research findings reaching out to hard-to-reach individuals and communities locally and beyond?

• Are our endeavors and prospects for future research addressing high impact priority areas in population health? Who gets to decide on the priorities? The community or researchers?

• How could our scholarly publications reach out to the nonacademic communities? What is our role and responsibility in such critical ‘translation/transfer’ process? If we study a particular region or research question in a community, is it our obligation to inform them of our findings?

• Is progress in reducing global health inequities measured in meaningful and sustainable ways? Other than researchers’ performance and productivity, is it possible to consider internal checklists for health equity and community-driven impact from our interdisciplinary work?

There is no simple answer to any of these questions – especially in times of an unprecedented global health crisis that has reversed many years of progress on poverty, hunger, healthcare and education. If our honest intention –for those occupying a privileged seat in academia– is to move the needle in the right direction, toward achieving health equity and closing the global North-South divide, then it becomes crucial that we learn how to adopt, adapt and sustain existing best practices to involve community and other stakeholders in research endeavors. Engaging communities in generating evidence for solutions to their health, social and environmental challenges has the potential to move the needle toward a more equitable and sustainable world.

Community-led, community-initiated, or community-driven research –formally known as Community-Based Participatory Research (CBPR)– brings us closer to achieving health equity, in particular among the urban poor and other vulnerable populations, often found in resource-constrained regions. CBPR is a process that begins with an understanding of the needs of people and communities and the identification of mechanisms to bring key community stakeholders into the entire research process, thus facilitating real engagement to identifying and implementing sustainable solutions. CBPR goes beyond approaching communities for individual research projects and maintaining the contact only during the lifetime of the study. It includes framing research questions, planning study design, implementing and scaling up best practices, and sustaining equitable research partnerships via orchestrated efforts, all under the same rigorous and high-quality research demands of academic work for “traditional” research. As we think about achieving our SDGs, we must have community-driven research become the norm.

Almost one year into the pandemic, I urge you to work with nonacademic researchers including non-governmental organizations, local governments, and policy makers, to address inequalities and injustices in our own backyards and translate research into programs that work for all. Looking back from 2030, we will continue publishing success stories on occupational and environmental health challenges and solutions, focusing on those that are relevant and timely. The critical question would then become whether our archives of knowledge have been able to contribute to real progress in reducing health inequities, moving the needle toward sustainability, prosperity and well-being for all. Engaging communities in research is undeniably the essential and enabling factor to achieve this noble goal.

Maria Brunette, PhD
Associate Professor, School of Health & Rehabilitation
Sciences, College of Medicine, Affiliated Faculty,
Integrated Systems Engineering Department,
The Ohio State University

Deputy Editor-in-Chief, Archives of Environmental &
Occupational Health
[email protected]