Alonzo Plough, vice president of the research-evaluation-learning unit and chief science officer at the Robert Wood Johnson Foundation, spoke at a Nov. 7 installment of the UW department of health systems and the Hans Rosling Center for Population Health’s seminar series. 

Plough addressed approximately 25 members of population health and an additional 50 members were present virtually via Zoom in a lecture detailing the health science system.

Plough began by describing how he and his colleagues from the World Health Organization (WHO) have noticed limitations in the current conventions of health technology, especially regarding disability justice and health equity. Plough emphasized how many existing health knowledge systems are based on outdated academic models, which has led to an underutilization of available knowledge and factors.

“We’re not talking about eliminating — we’re talking about an overdominance of a particular framework,” Plough said. “You cannot have a narrow biomedical model that helps you understand the fentanyl crisis; it just doesn’t work.”

Plough compared two possible frameworks for health science systems: a traditional closed reinforcement model that emphasizes academic collection of knowledge (such as peer reviewed papers) collected by experts, as well as a whole systems model which draws on knowledge from a wider talent pool outside of academia. Plough gave a specific example of a whole systems model with the National Institutes of Health’s Community Partnerships to Advance Science for Society program, which notably provides grants directly to community based organizations as part of health disparities research.

“We’ve got to challenge some of our fundamental assumptions about science and objectivity, what we admit as evidence, [and] this power gradient around developing knowledge that keeps us from incorporating very important community knowledge,” Plough said.

Plough also shared that the issues universities face, specifically to implement health equity in their research on population health, are transdisciplinary, making this goal challenging. 

He continued to explain how there are four main factors to persistent and inequitable health outcomes: disease prevalence, social determinants, political determinants, and structural determinants. All of these deal with differing academic subfields, such as public policy and sociology. 

Plough shared how the Robert Wood Johnson Foundation has been funding a health equity narrative in medical journals in order to make departments and researchers value equity and community knowledge more in health research.

“Our funding has gotten [the journal] Health Affairs to begin to do more blogs, more special issues on health justice, on climate,” Plough said. “[We’re] really trying to alter some of their classic reviewal structures so that new, good knowledge can get in.”

Plough concluded his lecture by emphasizing how the burden of this current issue of equity depended on students in the population health field, which he called the future of public health, specifically for their ability to influence health science as a way of knowing.

“How do we bring about a generational shift in how we think about health science in our generation?” Plough said.“How can we once and for all generate consequential scholarship … that creates a healthier and fairer world?” 

More information about the Robert Wood Johnson Foundation can be found online.

Reach contributing writer Jack Li at news@dailyuw.com. X: @jackli789

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