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Brighton & Sussex Medical School

Culture, society and health

BSMS > Research > Global health and Infection > Infection > Culture, society and health

Culture, society and health

Many complex social, cultural and historical factors, dynamics and processes simultaneously operating locally and  globally affect the health and ill-health of individuals, populations and nations. As these factors change, so do the challenges and opportunities for improving people’s health and wellbeing.

The Society, Culture and Health research group at the BSMS Centre for Global Health Research brings a critical social science perspective (predominantly medical, socio-cultural, economic and anthropological together with development studies) to the understanding of disease causation and management. Our research mainly focuses on understanding the political economy of health, ill-health and health governance and on using ethnographic and grounded research to inform health policy and practice.

We currently concentrate on five overall work themes: 

  • Social, Cultural and Historical dimensions of global interventions at the end of life
  • Macro-economic, historical and socio-political determinants of occupational injuries 
  • Elimination of NTDs though action on the social determinants of health
  • Design of community led, culturally sensitive health interventions
  • Stigma 
Researcher outside talking to a woman in a peach head scarf with others looking on

Social and economic determinants of health

NTD elimination through action on the Social Determinants of Health: the case of podoconiosis in Guatemala (Principal Investigator: Mei Trueba) 

Following from a previous research project financed by the University of Sussex this project aims to understand the socio-economic factors and processes that have led to the elimination of podoconiosis in Guatemala in order to support podoconiosis efforts in other parts of the world. This project is being undertaken in collaboration with the Centre for Health Studies (CES, University del Valle, Guatemala). 

The political economy of occupational health injuries: addressing the elephant in the room (PI: Mei Trueba)

Occupational Health and Safety (OHS) is increasingly being recognised as a growing, yet neglected, global health problem. Globally, over 2.3 million people are estimated to die annually for reasons attributed to work, and the International Labour Organization and the World Health Organization have recently called for urgent action and new solutions to tackle the persistence of work-related accidents and diseases. This project focuses on understanding the macro-economic drivers of occupational injuries in the Bolivian small-scale mining sector in order to advance OHS research knowledge and inform evidence-based interventions in Bolivia and beyond. This project is being undertaken in collaboration with the Bolivian network of women and Mining (RNMM). 

Vivir Bien/ Buen Vivir and post-neoliberal development paths in Latin America: Scope, strategies and the realities of implementation

Dr Mei Trueba is currently co-editing, with Dr Kepa Artaraz (University of Brighton) and Dr Melania Calestani (Kingston University), a special issue on the multifaceted meanings of ‘Living Well' and their policy translations in the Latin American Context. 

Exploration of the social and cultural dimensions of Mycetoma and development of a community prevention programme in Sudan (PI: Shahaduz Zaman)

Mycetoma is a slow-growing, destructive infection of the skin and underlying tissues. It is painful, disabling and reduce mobility which has a severe negative impact on productivity at household, community and national levels. It is associated with high levels of stigma which creates social isolation, reduces opportunities for education and increases the risk of poor mental health. Knowledge of mycetoma within health care systems is often inadequate. Diagnosis and treatment options are limited and the cost of accessing health care to ease symptoms can be prohibitively expensive. As part of a larger NIHR grant exploration of the social construction of mycetoma including social production of health disparities and belief in healing practices using critical medical anthropological perspectives is underway through a PhD project. A community intervention programme will be developed based on the initial exploration.  

Economic Evaluation of Health Care Interventions (PI: Natalia Ivashikina)

To help patients, doctors and other health care professionals make decisions about treatment and management of health issues, we need evidence about what works best. Health economics focuses on getting good value out of our limited health care resources. 

  • We investigate how healthcare resources are used to help people with health problems;
  • We design and conduct economic evaluations of new treatments, diagnostic tools and healthcare programmes;
  • We forecast and model outcomes of new treatments and healthcare programmes;
  • We provide policy makers with advice concerning the allocation of resources in health care.

Our current research topics cover following areas:

Economic Evaluation of community-based holistic care package for people with lymphoedema in Ethiopia (NIHR GHRU project);

Estimating economic cost of mycetoma in Sudan (NIHR GHRU project);

Evaluating costs and outcomes of public health strategies to contain scabies outbreaks in Ethiopia using a dynamic transmission model (NIHR GHRU project);

Estimating economic cost of stigmatised skin conditions (podoconiosis, mycetoma and scabies) for individuals and societies in Ethiopia, Rwanda and Sudan (5S Foundation project);

Evaluating innovative prescribing services (supplementary prescribing by dieticians and independent prescribing by therapeutic radiographers) and their effect on patients, staff and services in the UK, using a decision analytical model (TraDiP project, https://www.surrey.ac.uk/evaluation-independent-prescribing-therapeutic-radiographers-and-supplementary-prescribing)  

Arianne Presenting at the NNN Conference 2019

Ethics research

Mapping the ethical terrain prior to research studies using the Rapid Ethical Assessment methodology 

As the number of genetics and genomics studies in low- and middle income countries (LMIC) increases, exploration of the social, ethical and cultural implications of such studies is crucial in understanding the concerns and issues of the people living in these countries.

In addition, scientists in LIMC have had little opportunity to influence the public, including policy makers, governments, and researchers in other fields. This gap must be bridged by developing a community engagement strategy and work towards its execution to translate research findings to better life.

While at King’s College London, Prof Bobbie Farsides, together with her then PhD student Susan Bull, pioneered the Rapid Ethical Assessment (REA) methodology for information provision and consent processes in developing countries. The REA approach proposes that, prior to conducting research in a new setting, research teams should commit to a short, social and concentrated scientific examination of the site, concentrating on issues that could be relevant to recruitment, consent, information provision, data storage and reporting. This assessment then allows a study protocol to be introduced in a manner sensitive to the needs and preferences of the local population, making recruitment and retention of participants more successful.

REA has been used in a range of our global health studies so far and has a potential applicability in exploring ethical issues beyond biomedical research. We have used REA prior to studies on the genetics of podoconiosis in three regions in Ethiopia and in Cameroon in order to contextualise informed consent, and Dr Adamu Addissie did his PhD on ‘Adoption of Rapid Ethical Appraisal for Biomedical Research Projects in Ethiopia, funded by a Wellcome Trusting Training Fellowship. 

Man wearing white and holding an umbrella looking down

Community interventions

Partnership to ensure the sustainability of a public health palliative care project in Bangladesh through community theatre (PI: Shahaduz Zaman)

The aim of this AHRC funded interdisciplinary collaborative partnership project is to ensure the sustainability of a public health palliative care project in Bangladesh. This will be done through community theatre which will lay the foundations for a network to develop contextually appropriate strategies to address the challenge of public health palliative care in a resource-poor setting. This partnership also aims to provide a unique opportunity to the researchers and practitioners of the arts and humanities, medicine and development in both the UK and Bangladesh to interact, generate new insight and share knowledge between institutions and across sectoral boundaries.