Better Health For All

• by Serena Luchenski, Public Health Registrar, Health Education Central and North West London

The Chief Medical Officer’s Academic Fellowship has been a fantastic opportunity to cultivate my skills and knowledge in Homeless and Inclusion Health research.  Since April 2015, I have been based in the Department of Public Health Informatics at the Farr Institute of Health Informatics Research at University College London. My experiences this year have been exciting, varied, and have provided me with many new learning opportunities that will surely benefit my future public health career plans.

My main reasons for applying for the CMO fellowship were to develop my research network, to improve my academic profile, and to apply for a PhD. I have known for a long time that I would like to incorporate research into my public health career, but I had not found the right opportunity or dedicated time for making that happen. With my Fellowship drawing to a close in a month or so, I am amazed at all of the opportunities I have had over the last year. Below are a few of the highlights and my plans for what’s next.

Publications
I led a review of ‘what works’ in Inclusion Health to provide an overview of interventions that impact health and the social determinants of health for people with experiences of homelessness, drug use, imprisonment, and sex work.  I collaborated with several national and international experts from organisations including Pathway, Find & Treat, and the International Street Medicine Institute. The paper is part of a commissioned series and is currently under review at the Lancet.

I also had the opportunity to complete a previous research study that I did in Vancouver, Canada working with people who use drugs.  It was recently published in Drug and Alcohol Review, “Protective factors associated with short-term cessation of injection drug use among a Canadian cohort of people who inject drugs”.

This paper demonstrates the relative importance of the social determinants for promoting behaviour change – housing, employment, social support, and access to services were all found to be more important than addiction treatment in promoting cessation of injection drug use.

Conferences
I gave two oral presentations at the Lisbon Addictions Conference, one on my paper about cessation of injection drug use and a second on engagement with people who use drugs for harm reduction planning and policy (paper under review). It was a great conference and I met many new colleagues from the UK and across Europe.

I also helped to organise the Lancet UK Public Health Science Conference and co-chaired a very exciting oral paper session with the Lancet editor-in-chief, Richard Horton.  In March, I will be attending the Homeless and Inclusion Health Conference in London, which is a must-attend for anyone interested in this topic.

Patient and Public Engagement
As part of the Inclusion Health review, I developed new expertise in patient and public engagement. I organised a workshop with people with lived experiences of homelessness and social exclusion who volunteer as ‘peer advocates’ at a homeless health charity called Groundswell.   The workshop enabled me to provide context to the findings of the review paper and it has helped me to develop my future research plans.  I also discovered that I really enjoy public engagement and facilitation.  I have been invited to lead events or teach on several occasions off the back of this first workshop.

Teaching and Advisory Roles
I gave an exciting lecture on social determinants and homelessness to medical students where I presented alongside a group of experienced homeless health peer advocates from Groundswell. This was an enlightening teaching experience – I delivered the theory and the peer advocates shared their personal experiences. I am not sure who learned more – me or the students!  I also taught about social determinants theory to trainee homeless health peer advocates and was invited to join an expert advisory panel for an external evaluation of the Groundswell service.

Training Courses
I undertook an intensive course on Applied Research Methods for Hidden and Marginalised Populations at the University of Essex. This course was really interesting because there were attendees from many different areas of the world, and spanning disciplines from public health to conflict, migration, and child trafficking. I have already applied some of the methods that I learned during this course in my public engagement activities.

Future Plans
My Fellowship has allowed me to build a strong, interdisciplinary network of academics and health professionals from multiple organisations across the UK and internationally. I am planning to undertake a PhD when I complete my Public Health Training and I am presently preparing a PhD Fellowship application to improve preventative healthcare for people who are homeless. In the future, I hope to join up both of my passions for academia and public health service to become a leader in Inclusion Health research and practice. My Academic Fellowship year has been a catalyst for achieving these career aspirations.