Academic journal article Research and Theory for Nursing Practice

Health Inequities, HIV, and Public Health Practice: Examining the Role of Qualitative Research

Academic journal article Research and Theory for Nursing Practice

Health Inequities, HIV, and Public Health Practice: Examining the Role of Qualitative Research

Article excerpt

Although communicable disease public health practice has traditionally been based on numbers (e.g., incidence, prevalence), in the domain of HIV prevention and control qualitative research has recently become a more commonly employed data collection strategy. Of particular benefit, this approach can supplement the numbers which typically underpin public health strategies by generating in-depth understandings about how specific populations define, describe, and perceive their health and the factors that affect it. However, the use of qualitative research in public health must be explored; it cannot simply be accepted without reflection or analysis. To guide such an investigation, the work of Michel Foucault and Michael Hardt and Antonio Negri is used to examine two previous research projects that were undertaken by the author. The outcome of this analysis is the somewhat paradoxical conclusion that although qualitative research can enhance public health work, it may also be a strategy that generates the information that can be used for capturing and normalizing marginalized populations. Qualitative research, in other words, may be a technique that can be used to achieve biopolitical goals.

Keywords: critical analysis; health inequities; HIV; public health; qualitative research

According to Last (2001), public health "is the combination of sciences, skills, and beliefs that [are] directed to the maintenance and improvement of health of all people through collective or social actions" (p. 145). Public health is therefore a combined effort to optimize the health status of entire populations in educated and informed ways (Last, 2001). As part of executing informed initiatives in the domain of HIV care and management, public health practitioners collect population level data, which often requires laboratories, nurses, and physicians to report information about persons newly diagnosed with HIV to local public health departments; these reportable details typically include the age, sexual orientation, and sex of the individual diagnosed with HIV (Sullivan, Levine, McKena, & Weinstock, 2008). With these data, public health workers identify the groups burdened by HIV, the places where transmission occurs, and the methods by which transmission takes place. Thereafter, public health workers design targeted interventions that aim to diminish HIV transmission (Sullivan et al., 2008).

In recent years, public health workers have begun to supplement conventional public health measures (e.g., incidence, prevalence, etc.), with additional data about the distribution of these indicators among disparate populations (Osborne, 1997). Underpinning this new philosophy of practice is the belief that identifiable subpopulations should not be disproportionately burdened by the negative sequelae associated with any illness, disease, or condition, including HIV. Each person, consequently, whether a member of a visible or identifiable minority group or not, deserves the right to equal health status, enjoyment of life, and ability to pursue his or her dreams. Evidently, the principles of social justice and fairness, with the corresponding ideas of inequalities and inequities, frame current public health practice.1

Although the importance of research which aims to diminish inequities cannot be overstated, missing from current discussions about the public health research that examines such health inequalities, disparities, and inequities are sociopolitical analyses about the role and purpose of qualitative2 research. To address this gap, the work of Michel Foucault and Michael Hardt and Antonio Negri was used to examine previous research that was undertaken by the author. Specifically, the foregoing theories framed a critically self-reflective examination of two interrelated projects: One that was an exploratory qualitative study; a second, which was an intervention project based on the first study. In this article, therefore, the author's previous work functioned as "results," which were examined using the foregoing sociopolitical theoretical framework. …

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