Public health disciplinary excellence.

As a mature and productive discipline, public health needs three things. The first two requirements of public health excellence are familiar to us. First, we need access to the public health field so that we can, from experience, identify the problems that need to be resolved, and we need to maintain our access to the field so that we can gather our data. Second, we need skills in appropriate research methods so that we can turn the data gathered in the field into scientif ic analysis. If we stop there, we can produce highly polished research addressing important issues in public health. A steady stream of articles submitted to the Journal show this polish. We want to argue that this is not enough. Highly polished research articles that focus on narrow disciplinary concerns or that represent the interests of one institution are common. We know that they are a fact of life in a bureaucratic structure that sets one institution in competition with another doing very similar work. We also have a system that rewards detailed study of a limited range of phenomena. The problem is that we do not serve the discipline well if we publish articles, however professionally conducted, that address research questions that seem to have little relevance to public health in general but appear very important to one specific group or institution. If we follow this direction we run the risk of the Tower of Babel: public health researchers and practitioners who locate themselves in one or another highly constructed and ref ined tower can lose the capacity to communicate with those in other equally polished edifices. If we are to retain our capacity for communication despite the circumscribed conditions in which we work, we need the third requirement for a mature and productive discipline: a means of linking towers, recognising common threads that bind us to each other and to the discipline. We see the Journal as one such means of communication but it can only function in this way if the authors submitting to the Journal meet us half way. How can we make links between towers? A prime mechanism is through the literature. However segregated we may be in our locations, modern databases make it easy to locate a particular study not just in its immediate disciplinary literature but in the health literature in general. Let us take an example. If we want to evaluate a program to encourage the frail elderly to wear hip protectors, then we certainly need to engage with the literature on hip protectors and also with evidence about why they are not more widely acceptable. But there is a much larger literature addressing non-compliance in other health promotion programs and with other medical interventions. The failure of many interventions designed to improve compliance, irrespective of context, is immediately relevant to the study of hip protectors. It is, of course, relevant when we are planning our hip protector intervention but this literature should cer tainly be considered when we submit the report of the study for publication. In this way the authors can contribute to an understanding of compliance with hip protectors. By also contributing to the debate about the troublesome issue of non-compliance, the ar ticle gains additional interest and significance. Unfortunately, with a burgeoning literature in every public health discipline, a computer search can deliver dross as well as gems of wisdom. In order to tell the difference between the two, we need keen skills of critical appraisal. These skills are not easily acquired and many a student who submits to us an article from a postgraduate thesis or project has not managed to make the necessary distinction. The role of the supervisor, especially where the supervisor is a co-author, is to ensure that the links are made between the database the student is using and the public health significance of the analysis the student is asked to conduct, as it relates to that which is valuable in the literature. Again, the issue is that a study should be presented in a broader disciplinary context. Last, and perhaps most important, links between towers are constructed when we explicitly recognise the common commitments that we have to the public health field. Rather abstract concepts like social justice help to spin the threads that give us a common commitment. So, for example, a study that addresses the health status of a severely disadvantaged group in Australia can draw on our understanding of structural disadvantage, sharing that perception with a study addressing the international effects of violence against women. It is when these abstract public health conceptions are ignored that articles, however relevant, lose their power to persuade.