A Swansea University historian will play a key role in a new research project which aims to use humanities and social science expertise to help bring patient voices into healthcare research and practice.
The six-year interdisciplinary project, which has been awarded a grant of £2.8 million by the Wellcome Trust, will see Dr Michael Bresalier, from the Department of History, Heritage and Classics, partner with academics in Britain and Italy.
Epistemic Injustice in Healthcare (EPIC) is a partnership between researchers at Swansea, Bristol, Nottingham, Birmingham and the universities of Ferrara and Bologna to study how disparities in healthcare knowledge affect health experiences, wellbeing, and outcomes.
Some patients have reported that their testimonies and perspectives are ignored, dismissed, or explained away by the healthcare profession. These experiences can be classified as ‘epistemic injustices’ because, in some cases, they are based on prejudice and can jeopardise patient care and undermine trust in healthcare staff and systems.
Dr Bresalier, an expert in the history of medicine, will lead a case study on the development, implementation and impacts of ‘selective’ tuberculosis vaccination programmes for migrant, immigrant and ethnic minority populations coming to or living within Britain since the 1960s.
Through combination of archival, policy and oral history research, the study will trace how, and with what consequences, selective vaccination has been framed, understood, and experienced by medical practitioners, vaccine service providers, and im/migrant parents, children, and communities in different parts of the country.
In developing a long-term perspective on the ways in which uncertainties and injustices associated with selective tuberculosis vaccination have been negotiated and addressed, the study aims to better understand the roots and nature of the broader phenomenon of vaccine hesitancy in Britain.
He said: “I am thrilled to be a partner on this interdisciplinary project. It takes my research in an exciting new direction. It allows me to examine how vaccine policies are formulated at various levels, whose ideas and interests are included or excluded in the process, how medical knowledge is or is not shared, people’s experiences of and interactions with vaccination, and the ways inequalities in medical knowledge or understanding can affect communication about and access to healthcare resources.
“Epistemic injustice is an important framework for developing new insights into how differences in the knowledge people possess or communicate in negotiating health or illness (including vaccination) are socially determined and shape healthcare decisions and outcomes.
“Most importantly, I think, the framework provides a way to reflect upon what justice in healthcare might look like and what forms it might take.
“Collaborating with philosophers, psychiatrists, legal scholars and social scientists is a wonderful opportunity to consider how historical perspectives can help address issues of epistemic injustice and make healthcare more equitable.”