The promoters of good health

Transdisciplinary research to address global challenges was high on the agenda at the University of Bergen (UiB) in the 1980s. The Centre for Development Studies was established in 1986. And in the wake of the Brundtland report in 1987, the university established the Centre for International Health, the Centre for Environmental and Resource Studies, and the Centre for Health Promotion and Lifestyle Research (Hemil). Hemil is today organised as a department at UiB’s Faculty of Psychology, but it has retained its original Norwegian acronym.

Professor Maurice B. Mittelmark joined Hemil in 1995 and is one of the pioneers in the relatively new field of health promotion. He studies empowerment methods in health promotion, social environments, and public health policy processes. For many years, Professor Mittelmark was the president of the International Union of Health Promotion and Education, where he continues to serve as a vice president and editor-in-chief of Global Health Promotion (Sage).

We asked Professor Mittelmark to take a break from his hectic schedule to reflect over the work done at Hemil in its 25 year history.

This autumn the Department of Health Promotion and Development celebrates its first 25 years. You joined the Research Centre for Health Promotion, as it was known back in 1995. What was it about the centre that made you leave the United States for Bergen?

“Health promotion is a very new transdisciplinary field, and in the mid-1990s the Research Centre for Health Promotion in Bergen was a leading centre internationally, so I was very flattered to be asked to join the centre. Moving to Norway in 1995 gave me the chance to grow both academically and to live in a social environment in tune with my ideas about the nature of the good life.”

How is ‘health promotion’ different from ‘public health’? Is it important to make such a distinction?

“Public health tends to be dominated by medical thinking and a concern with curing and preventing disease. But health is also a positive idea, not just the absence of disease. The emphasis of health promotion is to foster good health as a resource for living well, and to strengthen peoples’ resources for robust good health, even in the face of the inevitable stresses and strains of life. It is this emphasis on health as a positive attribute that sets health promotion apart from traditional public health. However, many public health professionals are coming to view health from a health promotion perspective, and the differences between public health and health promotion are diminishing.”

Hemil was early to emphasise quantitative methods, particularly in survey research. Gradually it also developed qualitative research and is a pioneer in mixed methods research designs. As a candidate to the University Board at UiB recently, you raised the importance of keeping a long-term perspective. What strategic choices do you think made Hemil the way we see it today?

“I will mention just two. First was the decision to extend our research and teaching collaboration beyond the boundaries of this university and indeed, beyond the boundaries of Norway. We now have literally hundreds of collaborators on every continent. To develop and maintain quality collaboration requires extremely long term commitment, just as a satisfying family life comes from unending commitment to support by all its members. The members of the Hemil family are dedicated internationalists. The second choice I will mention was taken in 2010, when three professional areas decided to join forces to make the new transdisciplinary Department of Health Promotion and Development. There were the areas of Health Promotion, Child Welfare and Gender and Development. Today we are enjoying a high degree of research and teaching success that can be traced directly to that strategic decision.”

Hemil is a cross-disciplinary department and collaborates with researchers in other faculties. How have its cross-, trans-, and multidisciplinary approaches brought health promotion research forward?

“A good example of the importance of the transdisciplinarity approach to health is the arena of child development. The root causes of flourishing or floundering during the early development years are not primarily medical, they are social and they are complex. At the Department of Health Promotion and Development, anthropologists work hand-in-hand with sociologists to understand the impact on development of social roles in society, in the home, in the school and in the local community.”

“Social workers work with psychologists and health promotion specialists to develop child welfare services that are sensitive to the contexts of children’s lives, such as belonging to an immigrant family. Education specialists work with social psychologists to help schools become places where students – and staff and parents – thrive. No single discipline has all the answers, or skills to conduct the needed research. The hallmark of the Department is the type of transdisciplinary collaboration I have just described.”

You are yourself cross-disciplinary by training. How has your background in psychology and an epidemiology helped you in your own research and teaching?

“It has helped me to understand that the research problem should determine the research methodology, not the other way around. Researchers who are strongly focussed on the methods of a single discipline are like workman with few tools. If all you have is a hammer all problems will be ‘hammer problems’. If all you have is a wood saw, all problems will be ‘saw problems’. I try to help my colleagues and students have respect for the multiplicity of perspectives and methods that contribute to better health promotion research. We do not all have to be experts in the use of all our tools, as long as we have the right team of experts on the job.”

The department offers bachelor programmes in Public Health and Health Promotion, master programmes in Health Promotion and Health Psychology; Gender and Development; and Child Welfare; as well as an international master programme in Health Promotion. You have won teaching prizes and are known to put your students first. What is the biggest impact of the work you do at Hemil?

“I hope that my work advising masters and PhD students in their budding research careers has a lasting impact, and leads them to a productive and satisfying researcher life. I have learned that the single most important thing I do is illuminate their innate skill, their intelligence and their devotion to excellence – so that they come to see these qualities in themselves.”

Today Hemil carries out research in a variation of fields like stress and health, HIV / AIDS, gender and development, political violence and poverty, bullying in schools, child welfare and social inequality and health policies of different countries. What areas of research should have priority in the near future? Is it important to integrate teaching into this research?

“There is much talk these days about the need to integrate teaching and research. The idea is that universities have a unique niche in higher education, as places where student scholars rub elbows with senior scholars. The idea is that both benefit, just as the master and the apprentice are both meant to benefit in the skilled trades. Let us learn from the tradesmen. Integrating research and teaching is more than just delivering research-based lectures to students. All university students should participate in the academic staff’s research groups, doing research with senior researchers, and not just directed by senior researchers. We must move from an ‘us-them’ mentality, to appreciate students as colleagues who add positive value to our research, if we will only invite them in to the workroom.”