Jennie's presentation from her talk at the Lets Talk Research Conference 2017

1. A cau&onary tale:
Serendipity and a career in research
“We encounter a
linguis0c sage, walk
down the illustrious
halls of the Harvard
Medical School, a;end
the (serendipitous)
birth of penicillin, and
meet someone who
"manages serendipity"
for the U.S. Navy.”
“the book ..... represents
Merton's lifelong protest
against that rhetoric of
science that defines
discovery as anything
other than a messy blend
of inspira0on,
perspira0on, error, and
happy chance–
i.e. anything other than
serendipity”.
Jennie Popay
Professor of Sociology and Public Health

2. 1950’s Salford – eager
to get on with life
Late 1960’s : Last
cohort of unqualified
Voluntary Service
Overseas in East
Africa
Mid 1960’s : 2 years
unskilled work then
teaching assistant
for 6 months
Working in schools and adult literacy in
Uganda, Kenya and Tanzania

3. 1970’s: a tortuous path but spectacular views!
1950’s Salford – eager
to get on with life
Late 1960’s : Last
cohort of unqualified
Voluntary Service
Overseas in East
Africa
Mid 1960’s : 2 years
unskilled work then
teaching assistant
for 6 months
Off to University in
New Zealand to go
physical geography
and geomorphology!

4. 1970’s: a tortuous path but spectacular views!
1950’s Salford – eager
to get on with life
Late 1960’s : Last
cohort of unqualified
Voluntary Service
Overseas in East
Africa
1980s London moved into health
18 years fixed term contracts in
Universi&es & voluntary sector
Decades of opportunis&c grant capture
Various public appointments
Lots of networks built on way
Made friends and enemies
1994 Salford set up research centre – first in
NHS then a tenured post as professor
2000- 01 Professor University of Leeds
2001 – to present Professor Lancaster
Mid 1960’s : 2 years
unskilled work then
teaching assistant
for 6 months

5. Why the move to health?
Published 1979 A;ended lecture by Peter Townsend on poverty in the
United Kingdom on visit home and was converted to
social policy and a life 0me commitment to research and
ac0on to reduce social and health inequali0es

6. Health inequali&es – not how much money you have
but what you do with it?

7. Within countries: UK
Inequalities in life expectancy and
healthy life expectancy at birth
between more and less
disadvantaged areas of England
Women: 6 years difference in life
expectancy and 20.2 years difference in
healthy life expectancy between most and
least deprived areas
Poorest
areas
Richest
areas
Men-8 years difference in life expectancy
19 years difference in healthy life expectancy
h;p://visual.ons.gov.uk/how-long-will-
you-live-in-good-health/

8. Life expectancy by local authority areas in
England: 2009-13; greatest gap is 7 years for
women and 9 years for men
On average health of population
in the north is worse than that in
the south even when they are
living in the same socio-
economic circumstances
Within Country - The North South Divide

9. At the local level – health inequalities in Lancaster
Pattern of disadvantage
Lancaster
Inequalities in life expectancy by area
disadvantage – 10 years shorter for
men and 9 years for women in most
disadvantaged areas

10. 1. Practical wisdom & health inequalities
• individuals dominate
• but as accumulations of risks,
vulnerabilities and resiliencies
or sets of freely chosen
behaviours
Absence of people as
‘knowing subjects’ using
practical wisdom to make decisions
that are logical
in context of their lives

11. Many fault lines between lay and professional
understandings
• Practical wisdom connects experience and behaviour with material and social
context and presents health damaging behaviour as coping strategies
• Professionals/researchers fragment people’s experience into individual or
clusters of behaviours and/or lifestyle too often presented as ‘freely chosen’
• Practical wisdom reflects realistic assessments of limited opportunities for
control - professionals see fatalism, low locus of control or health ‘illiteracy’
• Lay people and professionals may share ‘values’ but interpret implications for
action differently e.g.
– Both accept parental responsibility for child safety but professionals emphasise their
educational role, parents’ emphasise responsibility of many agencies & people

12. Prac&cal wisdom & poli&cal literacy

13. 2. Questioning dominant
perspectives on health
(inequalities) and what is to be
done about it/theme

14. Public images of health
issues in UK
BreasTeeding
mothers offered
£200 in shop
vouchers
Paying pregnant
smokers to quit in
Glasgow
Get Paid to
Exercise and Live a
Healthier Lifestyle
– BUPA ini0a0ve
Pay children to
read books –
Pay4Performance
Obesity crisis: get
paid to lose
weight
Pay kids to eat
fruits, vegetables
Incentives and
the rise of nudge
Better lifestyles = better health

15. • Widening socioeconomic inequali0es = widening health inequali0es
• Evidence suggests life expectancy improvements faltering as austerity bites
• Response – more about that in a moment…….
An alternative
perspective
Enhanced social jus&ce =
be]er health (equity)
An unjust and sickly Britain
Most unequal Least unequal
Income inequalities in 30 high income countries
Non-decent homes by tenure

17. 3 Health Inequali&es & Community Control
• Study of Indigenous suicide in Bri0sh Columbia
– Significantly elevated suicide rates (overall 5 0mes greater between 1987-1992)
– But not uniformly distributed across 1st Na0on groups:
– So, aboriginality per se is not a risk factor.
• Tested the hypothesis that ‘Cultural con0nuity’ explained differences
• Measures of cultural con0nuity
reflected degree of ‘community
control’
• history and success of land claims;
• self government;
• control of services;
• Dedicated cultural facili0es
Personal persistence, iden0ty development and suicide, Chandler,
Lalonde, Sokol, Halle;, Monogr.Soc.Res.Child.Dev. 2003:68(2)

18. Evalua&ng Experiments in Community Empowerment
Local Trust & Big LocalPeople’s Health Trust &
Local Conversations

19. Early learning: in context of
cuts in pubic services and
financial crisis in the NHS
Community and pa0ent
centeredness risk becoming
DIY health and welfare.
The
Political
Paradox

20. 1970’s: a tortuous path but spectacular views!
1950’s Salford – eager
to get on with life
Late 1960’s : Last
cohort of unqualified
Voluntary Service
Overseas in East
Africa
1980s London moved into health
18 years fixed term contracts in
Universi&es & voluntary sector
1990s onwards back north….
Mid 1960’s : 2 years
unskilled work then
teaching assistant
for 6 months
?
what
lessons
from
this
career?

21. • Many surprises along the way – but least likely events may offer opportuni0es
• Missed opportuni0es aren’t a disaster but formal qualifica0ons more important now
• Most sectors value pathways they know – but academia may be par0cularly conserva0ve
• Building and maintaining rela0onships over 0me is really important
• Learning to deal with difficult situa0ons and difficult people very valuable
• Working across sectors has value: acquiring diverse knowledge and understanding
• Gender ma;ers –combining work and family makes a career more difficult to maintain
Lessons from my career…….
• Leaving things to serendipity has some disadvantages but
can be more exci0ng and rewarding in long run
• I may have followed a path more tortuous than most but
‘Happy Chance’ creates academic mongrels – we are
tough but it can be harder to demonstrate worth