Written by Andrea Charise, Associate Professor, Department of Health & Society, University of Toronto
As an interdisciplinary collective of academics trained in a range of fields from the arts to social science to clinical sciences, we have witnessed first-hand a crucial problem in how health is taught and communicated at the post-secondary level. What is often missed, but is critical to contextualizing scientific findings, are examinations of the assumptions and methods used to conduct health-related research.
This omission reflects a problem in Canadian colleges and universities, which generally deliver post-secondary curriculum using a single-discipline approach. A single-discipline approach to health education does not engage the full picture nor provides the groundwork for innovative, equitable solutions in the future.
At the post-secondary level, for example, a microbiology course might focus on lab-based methods used to diagnose whether someone has developed antibodies to a disease like COVID-19, while a typical public health course might focus on the mechanics of contact tracing.
Deeper understandings of health require a co-operative investigation of the various frameworks, techniques and assumptions that guide research practices and how they are communicated.
Universities must fundamentally change their approach to teaching health-related knowledge. It is time to commit to what we call “radical interdisciplinarity”: a sustained inquiry into interactions between biography, arts, culture, history and societal organization that contributes to debates about political, social and economic determinants of health.
Complex issues, complex research
From local to global health issues, traditional, single-discipline approaches are inadequate training for our future carers and health workers. Along with the specialized, deep knowledge that characterizes most undergraduate education, we need to train students studying health issues to respond to the interdisciplinarity of health itself.
The ongoing coronavirus pandemic can be used to illustrate this radically interdisciplinary approach; such an approach informs a new team-taught course, “How to live in a pandemic,” being offered at the University of Toronto Scarborough’s department of health and society.
Quantitative approaches, which focus on numeric data, are suited for research focused on the development of treatments using experimental designs, particularly randomized controlled trials. Projecting the number of infections and deaths resulting from the virus is done by statistical models of infectious disease, using secondary data.
Qualitative approaches, by contrast, are best suited for examining the experience of, for example, racialized women working as front-line service providers. In this case, one-on-one in-depth interviews capture the meanings and interpretations of their circumstances, particularly in light of the impact of systemic racism on health.
Beyond qualitative and quantitative approaches, arts-based health research methods are gaining traction. Creative arts — including music, theatre, writing and visual arts — have been increasingly integrated into more conventional forms of health research and education.
Canada’s first undergraduate program in health humanities was launched in 2017 at the University of Toronto Scarborough. Integrating these insights with arts-based methods can further illustrate the diverse expression of these issues in the creative lives of everyday people.
Social distancing and health inequity
One of the challenges of the current pandemic is addressing how COVID-19 is experienced differently by individuals and communities. Lessons from previous epidemics show that we are not created equal in terms of exposure to and consequences of disease: racialized, poor and sexual minorities are examples of communities that have suffered disproportionately.
It is crucial to disentangle the social, environmental and economic influences of the COVID-19 pandemic across different age, gender and class lines. For example, during the COVID-19 pandemic, social distancing, self-isolation and other practices aimed at controlling viral transmission may have a particular impact on the mental health of lesbian, gay, bisexual, transgender, queer, two-spirit and intersex (LGBTQTSI+) people.
Members of LGBTQTSI+ communities are particularly vulnerable to the negative consequences of social isolation. These contribute substantially to higher reports of mental illnesses such as anxiety, depression, suicidal ideation and acts, self-harm and controlled substance dependence.
Sociological and public health research indicates LGBTQTSI+ people have less access to socioeconomic resources, employment opportunities, health care and other forms of social support that are available to their cisgender heterosexual peers.
Better understanding the impact of responses to COVID-19 on the mental health of LGBTQTSI+ people can help ensure that all members of our society — regardless of sexual and gender identity — receive culturally appropriate and inclusive care.
Living and learning in a pandemic
As university-based health researchers and educators, our approach to the study of COVID-19 differs from conventional health education approaches. We lead with the principle that it is valuable, and in fact ethical, to commit to radical interdisciplinarity inside and outside the classroom.
A basic understanding of the research methods generating the body of pandemic scientific knowledge is essential to critically appraise the evidence, by recognizing the methodological strengths and limitations of any specific disciplinary approach.
Universities must find ways to model the multi-sectorial, interdisciplinary solidarity required to face the escalating complexity of 21st-century global health. The COVID-19 pandemic gives us a moment in time to overhaul health education — and perhaps to teach us all how to better prepare to live in the midst of this and future pandemics.