by Dr Clare L Phillips
At the end of 2019, I completed my PhD journey at Flinders University. What a ride. As for any PhD graduate this was an exciting moment. However, I didn’t really plan to do a PhD, and, I definitely did not plan to do a cross disciplinary PhD in public health and political science.
I started my academic career as a trombone player – well, I can’t say that was really an academic time for me, but I did study a Music Degree at University, which meant I could play my trombone all day (something I thoroughly enjoyed!). After spending some time working as a music teacher I went back to university and studied an Arts Degree (professional writing & communications) and fell into a series of jobs in health, as a communications specialist. At this point I fell in love with health but mainly from a public health point of view – where social justice and equity issues caught my attention.
At this stage I had no intention of starting a PhD. However, after completing a Masters of Public Health (Research) and with a significant amount of work-related experience in this area, the opportunity to do a PhD arose and I entered my candidature feeling reasonably prepared within the discipline of public health.
As for political science? That came from left of field – my PhD candidature (and scholarship) was part of a project that proposed we explore ‘agenda setting’ in the Australian health policy environment. At the time I signed up I don’t think I really knew this would steer me towards using political science theories, however, as I began reading on this topic I could see that this would be integral to my project.
It is fair to say that this part of the project was very scary in the beginning, however, I am pleased to report that after much study, and, supervisory insight (a special thanks to Cassandra for her support in this area) I have come out the other end alive! When I have moments where I find my expertise in this area hard to believe, this is qualified by one of my examiners who stated:
‘This thesis is original and ground-breaking in its approach and methodology, combining political science and public health, as well as providing new substantive evidence and insights into child health policy in the Australian context’.
My PhD is titled ‘A cross-disciplinary study on formulating child health policy with a focus on the social determinants of health – an Australian perspective. While I’m not going to go into too much depth here (you can read my thesis for more details) I will outline a few of the key findings:
- There are relatively few examples of original research that focus on public health and adopt a political science framework to guide the design and analysis of the study (only 12/25 papers included in my literature review – see Chapter 2).
- I argue there are four constructs that assist in understanding the agenda setting and policy formulation process across these disciplines – politics, ideology, leadership and credibility.
- The evidence on the social determinants of child health and health equity appears to have reached the Australia health policy agenda at a surface level, but there is more work to be done to ensure action is taken in this area (only 10% of strategies across the 17 policies analysed in my research outlined any plans in this area – see related BMC Public Health article).
- Despite this there are some excellent examples of Australian child health policies (I selected four of the best examples in Australia for my study) where policy actors have attempted to push the boundaries in this area, and, in my study those that were involved in this process provided useful insights into why. (I interviewed 27 policy actors involved in the formulation of these policies – see Chapter 4).
Some of the lessons learned from the interviews with policy actors were:
- It is important for policy actors to understand the best way to frame an issue to soften up the policy agenda – some of the factors that were successful in my study were early childhood development, health equity, and child rights.
- If policy actors want to successfully advocate for progressive policy change in Australian health departments, they need to work towards building a cohesive policy network, including a range of leaders; support the establishment of guiding institutions specific to the issue and facilitate extensive community consultation.
- I argue there are a range of tactics (and storylines) that policy actors use to navigate the neoliberal policy measures that preference individualised healthcare and/or behavioural strategies to improve child health in Australia. Based on my interviews I divided these into four categories including extension, selective, adaptive and diversion (see Chapter 5).
- My thesis demonstrates that by applying a political science lens to the design and analysis of my study I was able to unpack ‘the politics’ of the agenda setting and policy formulation process in a way that will inform future policy advocacy efforts in public health – especially those that require complex solutions – as do the social determinants of child health.
So, while I have not really managed to break down my PhD journey into a short story (as was the brief for this blog), I am pleased to report that through a rather unexpected academic pathway (trombonist, to health communications specialist, to public health researcher…) to completing my PhD across two insightful disciplines, I have established an area of research that I intend to continue building on… and, feel I have played a small part in adding to this emerging (and important) cross disciplinary field of research.