• Open Access

Capacity building in public health: the role of this Journal


Journal contact details
Mail:Australian and New Zealand Journal of Public Health, PO Box 351, North Melbourne, Victoria 3051.
Street deliveries:c/- SUBStitution Pty Ltd, 1st Floor, 484 William Street, Melbourne, Victoria 3003.
Phone:(03) 9329 3535Fax:(03) 9329 3550

In July 2008, many of the readers of the Australian and New Zealand Journal of Public Health attended a Congress of the four Australian organisations that focus their attention on promoting the health of the public. Plenary speakers drew our attention to the ecological crisis arising from global warming, and its health implications. Clearly what is needed is global action to bring about the profound social change needed to reorient our way of living, to make it sustainable. The issue of global warming has not been at the forefront of the political agenda in Australia in the past decades. We now need rapid action to build our research capacity not only in analysing various aspects of the ecological crisis but also in devising ways of bringing about the radical shift in public attitudes that is needed.

Public health has a good historical record in the difficult task of changing social values. We recall the initiatives for protection against infectious disease, for smoking cessation and for safe childbirth. Our efforts are marked with an approach that includes change in individuals, in social groups and settings, and in the political and cultural contexts. It is this versatility that we now need to bring to bear on the problem of global warming. As part of the Journal's contribution to the debate, we encourage authors to submit articles that will build a sound evidence base for change.

We recognise, of course, that any one researcher, or team of researchers, is unlikely to have the resources to address issues ranging from the challenge of changing individual behaviour to bringing about a shift in culture. Public health, however, is multidisciplinary and different contributions from its constituent disciplines can encompass this broad range of topics. In addition, while research may address a problem at one level of the system, researchers are well aware of the contribution of the other levels. So, for example, when recommending substantial change to farming practices in Australia, we know that we must also recognise the potential impact on regional communities and the potential risk to disadvantaged people if the cost of food rises sharply.

While we are drawing attention to the need for articles about global warming, we are not suggesting any substantial departure from what the Journal currently does. Through the process of review and publication, our role is to contribute to capacity building for public health in Australia and New Zealand, and elsewhere. We retain our interest in traditional areas of concern, reflected in the articles that alert to us continuing problems with infectious disease, tobacco use and safe childbirth. These concerns are placed alongside areas that have been neglected in recent years, like occupational health and safety. That leaves room for building capacity in addressing important, emergent health issues, never forgetting the methodological debates that are required to ensure that our research is scientifically rigorous.

Authors published in this Journal contribute to our capacity-building role in public health by following procedures that ensure that their work is easy to review and a pleasure to publish. They bring to each paper their extensive knowledge of the literature in a field. This provides the basis for a literature review that shows that their research makes a significant, new and important contribution to public health evidence. Next, they outline their research methods and data analysis in such a way that we can judge whether there is a scientifically rigorous path from research problem, to research methods, to conclusions. Our preference is to have authors spell out clearly the implications for practice and policy that derive from the article, acknowledging any caution related to the limitations of the study.

It is worth noting that the cost of our capacity-building activities is borne by the relatively small membership of the Public Health Association of Australia, which funds the Journal and accepts, free of charge, articles from any author who wants to contribute to the Journal. In return, many of these authors then contribute by reviewing papers to ensure that what we publish meets good scientific standards — and we are duly grateful. Capacity for public health research and advocacy is not static and we encourage early-career researchers to become reviewers for the Journal and to contribute their work. Where we can identify such authors, we try to ensure that they receive helpful recommendations from reviewers for revision or, in the case of a rejection, for submission to a different journal.

While we are aware of the direct contribution of the Journal to public health capacity, the Editors sometimes also see practices that undermine that capacity and deplete the scarce resources of the Journal. We think the emphasis on publication that is current in our universities and research institutions may be causing an increase in the submission of poorly developed articles. Sometimes these come from a thesis or are written by a junior member of a research team. If our reviewers provide thoughtful and helpful reviews in the belief that they are responding to a paper by an early-career researcher, that is to their credit. However, it is a problem if we then see what our blinded reviewers cannot: that senior researchers and academics are co-authors on the paper but have clearly made little contribution to the structuring and editing of the paper. There should by now be a good understanding of the rules for contributing authorship: all authors are required to make a substantial contribution not only to the conception of a research project or the supervision of a thesis but are required to contribute to, and vouch for the scientific integrity of the article. This protects our reviewers from providing input that is reasonably seen as the responsibility of senior co-authors. To date, we have avoided the bureaucratic approach of asking all authors to state explicitly what their contribution is. We invite comment on whether it would be helpful to early-career researchers in dealing with ‘honorary’ authors if we ask for such a statement.

In this issue

John Mathews gives a sobering account of end-stage kidney failure among Indigenous Australians, showing an 8 to 10-fold greater risk, a 15-fold difference by the age of 50, and even greater risks for Indigenous Australians living in some remote communities. Yuejen Zhao and colleagues found remote Aboriginal communities in 2005 had a higher prevalence of various chronic diseases, with considerable under-diagnosis.

Culture and language are important. Della Maneze and colleagues surveyed the use of Kava among Tongan men. Consumption is high and linked to culture. Danielle Esler and colleagues developed and tested a depression screening tool modified for use with Indigenous people. Kam Cheong Wong and Zhiqiang Wang carried out a bilingual health survey in a Chinese community in Brisbane. Two-thirds of recipients chose to complete the questionnaire in Chinese and they were significantly different.

Child abuse and neglect is still with us. Melissa O'Donnell, Dorothy Scott and Fiona Stanley show high levels of notifications and argue for a public health approach focused on preventative services. Marc Tourigny and colleagues in Quebec, in a telephone survey of more than 1,000 adults, assess the prevalence of sexual, physical and psychological violence. More than a third had experienced at least one form of violence. Co-occurring forms of violence have serious long-term repercussions. Devon Indig and colleagues used the NSW Minimum Data Set for Alcohol and other Drug Treatment Service to recommend treatment better targeted to the needs of young people attending specialist treatment centres.

Parents are important too. Belinda Morley and colleagues show widespread parental concern about food advertising and strong support for tighter restrictions. Robert Scragg and colleagues reviewed data from the 2005 New Zealand National Survey finding that attachment to parents played a major role in low levels of smoking in adolescence.

Under infectious diseases, Robert Dunstan and colleagues provide a systematic review of the emerging viral threats to the Australian blood supply. Kirsty Hope and colleagues show that emergency department data can lead to early identification of outbreaks. Clare Heal and Rosanne Muller argue that general practitioners’ can do better with contact tracing. Sanjyot Vogholkar and colleagues show that healthcare workers are themselves at risk of infectious diseases.

Cancer remains an issue of concern. Janet Jopson and Anthony Reeder support ongoing concerns about indoor tanning services. Lauren Krnjacki and colleagues demonstrate that pathology reports are a valid source of information for colorectal cancer. Colin Luke and colleagues in Adelaide explore the characteristics of cancers of unknown primary site.

In midlife, in retrospect, many women report having had unwanted pregnancies according to Edith Weisberg and colleagues. Steve Riddell show problems with the way in which antenatal cocaine use has been assessed.