Health economist, Professor Glenn Salkeld, joined the University of Wollongong in February to take up the role of Executive Dean of the Faculty of Social Sciences.
Formerly the Head of the Sydney School of Public Health at the University of Sydney, Professor Salkeld provides an overview of his highly regarded research career, and his early impressions of UOW, below.
“I was the first person to be awarded a National Health and Medical Research Council (NHMRC) fellowship in health economics – that was in 1987 – and the topic I examined was the cost effectiveness of breast cancer screening. This feels like ancient history now, because now breast cancer screening is such an integrated part of the healthcare scene.
That was undertaken in the Department of Community Medicine at Westmead Hospital, headed by Stephen Leeder, now Emeritus Professor of Public Health at the University of Sydney. In 1992, I got a lectureship in health economics there and spent my career - up until this point - at the University of Sydney.
In the 1990s, there weren’t that many health economists around. So I found myself making connections in all of these different disciplines – epidemiology, statistics, anthropology, health promotion.
We were all interested in many ways in the same health questions and topics but of course had a different disciplinary perspective on it. It was brilliant training because the culture was one in which you would never pose a research questions in isolation of other points of view or disciplines.
So for me, this environment manifested itself in our first NHMRC program grant, in 2001, on which we had a multidisciplinary team working on a project called the Screening Test Evaluation Program (STEP). We were funded to be an independent critical voice of issues surrounding population based screening.
There’s lots of screening – there’s bowel cancer screening, breast cancer screening, osteoporosis screening, screening babies for certain conditions at birth. But actually, not all screening is beneficial.
Part of STEPs role, over the 15 years it has been running, has been to evaluate proposals for population health screening. For example, we evaluated the HPV immunisation program, as well as investigated the potential for prostate cancer screening – but on prostate cancer the evidence is not there.
The major paradigm shifts that our group has been responsible for is – and it sounds really simple, but it’s powerful – is that you really need to systematically consider the benefits and the harms of screening at a population basis, and also to promote the idea of informed choice – that you can’t just take a paternalistic view that all screening is good.
A lot of the work I led on the STEP grant was the development of online decision aids which capture the evidence base for screening and/or treatment; capturing that important part of patient preference.
When you take the quantitative estimates of the benefits and harms, and match it with patients’ general preferences about life and their health using an expected value equation you can come up with a recommendation or opinion.
One of the top cited papers to come from this project is on informed choice, published in the BMJ which is on the vanguard internationally of saying we really need to think critically about this.
STEP has been funded for 15 years, coming to a close at the end of June this year. I’ve been extremely fortunate to be a part of such an influential research group, and now I’m looking forward to what’s ahead here at Wollongong.
To me, what brings the Faculty of Social Sciences together is our common interest in social change and social impact. All of the things that influence people’s choices in daily life, whether as an individual, as part of a household, or part of a community and how people are given opportunities to fulfil their potential in life.
So from a social sciences point of view if we’re about social change and impact, how do we measure that? I’m personally committed to finding effective ways of measuring impact, because professionally it’s been a really important part of everything I’ve done, but also now because consideration and measurement of impact is demanded by funding agencies.
What impresses me so far – and I had heard of this long before I came to Wollongong – is the high level of collegiality amongst staff here.
Also I’ve noticed that there are processes are in place to empower PhD students to have confidence take charge of their ideas and that a PhD is not viewed just as a transaction, not just a piece of work, it’s actually relational. Maybe that’s no different to what most universities have, but I’ve seen it here and I’m impressed by that.
I’m a strong believer in doing a few things well so part of the challenge is to really focus – build reputation, build impact, and of course part of that must always be journal articles, publication citations and of course the thing that all universities want – and Wollongong is better positioned to have it – is engagement with community.
Early Start is one of the great opportunities for community connection here. Yet we can’t lose sight of how it can create broader prospects for our research as well. We’ve seen people coming to Wollongong because it offers an opportunity that other universities cannot, attracting leading academics from the UK for example. It’s essentially ‘turbocharging’ our research, building our capacity for postdoctoral positions, as well as extending for our national and global networks.”