Welcome to Leigh Turner, PhD, who joins UCI Public Heath as a new Professor of Health, Society, & Behavior

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Question: Dr. Turner, what drove you to pursue a career in public health? Academia?

I completed my PhD at the University of Southern California’s School of Religion & Social Ethics. From graduate studies to present, I’ve explored the study of ethical issues related to medicine, health care, public health, and biotechnology. One of my earliest peer-reviewed publications addressed bioethics, public health, and firearm-related violence in the U.S. As important as it is to be responsive to ethical issues in clinical settings, public health research, public health policies, and the practice of public health require addressing a wide range of challenging ethical issues. I was drawn to the field of public health by the importance of such topics.

What might have once seemed to be questions of interest mainly to academics are now part of our daily lives as we all navigate myriad ethical challenges related to the pandemic. For example, should academic institutions mandate that students, staff, and faculty members be fully vaccinated against COVID-19 before being permitted to return to campus? Should ‘vaccine passports’ be used as a means of facilitating international travel for vaccinated persons? How should vaccines and therapies be distributed in a fair and just manner when supplies are limited? Should residents of the U.S. have access to booster shots before individuals in many countries have yet to receive their initial vaccine shots? Such questions all need to be informed by relevant evidence, but they also need to be informed by analysis, reason-giving, and argumentation about what consideration to give to particular values. There’s also the difficult question of how moral norms should be translated into particular practices and policies. I see the field of bioethics in general and public health ethics in particular as spaces where it is possible to study and address such matters and contribute to public debate and policymaking processes.

Academia has been a good environment for me. I enjoy research, writing, teaching, and want to continue to learn. And I appreciate the friendships and collegial bonds I’ve made over the years as a member of various academic communities. I’m particularly excited about having UC Irvine as my new academic home. I’m really impressed by the people I’ve met here and I’m looking forward to becoming part of the UCI community.

Q: What do you hope to achieve in the first five years at UC Irvine?

I’m enthusiastic about working with my new colleagues and building a new center or program for bioethics here at UC Irvine. I know five years will pass quickly, but I’m optimistic there’s a lot we’ll be able to accomplish during that time. I want to begin the process by working with the incredible talent that is already here and engaged in important work. I’m looking forward to developing new research, teaching, and community engagement initiatives. I’m hopeful it will be possible to attract faculty members and students from across UCI’s various Schools as well as from the College of Health Sciences.

Five years from now, I hope we will have built a center that is supportive of students and faculty members interested in public health ethics and bioethics-related scholarship. I want to help create a collegial, inclusive, and welcoming environment, and I’d like to see it contributing to research and teaching at UCI as well as to broader public conversations and policy debates. I’m glad to have initial support provided by the Program in Public Health, the Sue & Bill Gross Stem Cell Research Center, and the Institute for Clinical & Translational Science. In terms of my own research program, I’m grateful for funding from The Pew Charitable Trusts.

I’m particularly excited to be arriving at a time when the Program is on its way to becoming a School of Population and Public Health. Over the next five years I hope to make meaningful contributions to research, teaching, and community service related to public health ethics, public health policy, responsible conduct of public health research, and global health ethics.

Q: What are the crossroads that have come up between your work and the pandemic?

The COVID-19 pandemic has generated commercial opportunities for individuals and businesses willing to take advantage of the widespread distribution of misinformation and disinformation. I’ve paid particular attention to businesses and clinics selling unlicensed and unproven stem cell products as purported treatments or preventive interventions for COVID-19.

I’ve published an article in Cell Stem Cell on the subject and I’m currently working with several friends and colleagues on a related article. Some of these businesses have already attracted the attention of the Food and Drug Administration or Federal Trade Commission. In contrast, other clinics continue to sell stem cell products marketed as putative therapies for COVID-19 but lacking convincing evidence of safety and efficacy as treatments for COVID-19. Long-COVID is another marketing opportunity as stem cell clinics and other facilities pivot to pitching their products to individuals suffering from long-term effects of being infected with SARS-CoV-2.

Q: The pandemic has put public health on centerstage: where does public health go from here? And how can higher education and institutes of learning help so we as a society are in a better place moving forward?

In terms of where public health goes from here, I can imagine a range of scenarios, but let me describe two very different possibilities that seem plausible. The first imagined pathway involves learning from the COVID-19 pandemic and making substantial changes to our institutions, health-related policies, and support for public health. The U.S. was deeply unprepared for COVID-19 in terms of federal leadership, availability of personal protective equipment and other supplies, staffing of public health agencies, and partnerships between crucial federal and state actors. Since the start of the pandemic, a substantial amount of effort has gone into developing more thoughtful public policies, stockpiling supplies, and addressing personnel shortages. As awful as the pandemic has been, and not to minimize all the losses and suffering that have accompanied it, perhaps it has made the U.S. and other countries better prepared for future public health emergencies.

On the other hand, I can imagine a scenario in which lessons learned are swiftly forgotten, and we are no better prepared for the next pandemic than we were for this one. I hope we don’t revert to longstanding patterns of undervaluing and underfunding public health institutions, public health professionals, and public health research and policy, but there are already signs of widespread interest in putting the pandemic in the rearview mirror. That’s an understandable reaction, but we need to try to learn from what we’ve experienced. I’m hopeful some needed changes to institutions and policies will emerge from the pandemic, but I don’t know which path the U.S. will take.

Academic institutions have all kinds of roles to play before, during, and after pandemics. They need to play substantial roles in countering disinformation and misinformation and helping promote evidence-based policies, practices, and public understanding. They ought to be important contributors to public health policy development, analysis, and critique. They should be involved in the translational process of developing and testing safety and efficacy of investigational products. They have roles to play in infectious diseases research, epidemiology, health services research, and social sciences and humanities scholarship. Universities are – and need to be – core public institutions capable of responding in meaningful ways when pandemics and other social crises occur.

Q: What do you enjoy most about teaching? What has been the most rewarding part about mentoring and training future public health practitioners?

Seminar courses can be really enjoyable and intellectually engaging, especially when everyone arrives well-prepared and there is a lot of animated discussion. I used to serve as the Graduate Program Director for the Master’s Specialization in Bioethics at McGill University in Montréal, Canada. Teaching in that program was a very positive experience, in part because I got to know the students well and also because of what they brought to the seminar room.

I plan to draw from that experience when developing public health ethics courses and other bioethics-related courses here at UCI. In terms of mentoring and training future public health practitioners, many of my students have arrived with substantial prior training and experience in medicine, the health sciences, the social sciences, and other fields. I’ve learned a lot from my interactions with them and I appreciate their willingness to grapple with challenging ethical issues in public health practice and policy. We’ve had a lot to discuss since the start of the pandemic.

Q: Share with us a project, study, or publication that you were part of where health equity had a central role.

One of my research programs addresses ethical, legal, and social issues related to cross-border health-related travel – sometimes described as “medical tourism” – and globalization of health services. Some countries have tried to brand themselves as destinations for patients seeking affordable, timely, and high-quality health care.

One claim often made by advocates of such national initiatives is that the economic returns from providing medical care to large numbers of international patients will trickle down and improve access to health care and health equity for underserved local communities. It is possible to construct theoretical models in which revenues generated from treating international patients can be used to promote local access to health services and support health equity.

In practice, however, outcomes often are very different, with local communities unable to obtain affordable care at medical facilities targeting international patients and revenues generated from such activities flowing to hedge funds and other investors in private hospitals rather than being distributed in a manner that would promote health equity and improve domestic access to care. Absent appropriate regulatory structures and effective oversight mechanisms, claims about plans to ameliorate inequities sometimes lead to further inequities.