Welcome back to our occasional “Better Know a Ronin Scholar” series, where we learn more about the research and other activities of our Research Scholars. Earlier this month, I talked to Research Scholar Michele Battle-Fisher (pronoun: she/her). Michele’s interdisciplinary research spans public health, complex systems and bioethics. Michele wears many hats. In addition to being a scholar at the Ronin Institute, she is an Assistant Adjunct Professor at Wright State University in Ohio, a member of the Bertalanffy Center for the Study of System Science, and the author of Applications of Systems Thinking to Health Policy and Public Health Ethics. She was a TEDxDartmouth speaker and a participant in the MIT Press Pitchfest.
Welcome Michele! 2020 has been a bit of a doozy of a year thus far. How are you holding up?
Thanks for having me today. This is kind of cataclysmic for me. Between Black Lives Matter and COVID, I’m kind of in overload. But I think it also brings to the point why I do the work that I do in public health: looking at the ethics and complexity of health care systems. So right now, the ethics are: “why do we have a horrible public health system when it’s obvious we were in need of one? And when we were in need of one, why were we not prepared?” We have an ethical issue of where we’re allocating our money–whether it needs to be on the clinical end or it needs to be on the preventative end. In addition, public health does well in expressing the overarching social determinants that make staying healthy individually and as a population overwhelmingly difficult. Yet, public health continues that fight. As a true Ronin, I use a new angle to add to the social complexity afoot.
Why do we have a horrible public health system when it’s obvious we were in need of one? And when we were in need of one, why were we not prepared?
COVID-19 is showing that we act in–at least in the United States–very much from a reactionary position. We deal with our problems when they happen. With this pandemic, I hope we will have a larger discussion of the pre-existing health disparities of people of color, LGBTQ, plus disability. The list could go on and on. It illuminates the holes we have in society and how some of us are falling into those holes. And they’re not throwing a rope in order for us to get us out of that well. So I really dedicate myself to that work and I hope that it’s doing some good.
You published your book, the Applications of Systems Thinking to Health Policy and Public Health Ethics by Springer back in 2016. It seems to have even more relevance now that public health is front and center. Is there more interest in that scholarship?
In 2012, I took part in a research program with the National Institutes of Health, it was called ISSH (Institute on Systems Science and Health), that brought together 45 competitively selected researchers in the areas of agent based modelling, social networks and system dynamics. I reaffirmed my love for systems there.
I started writing the book back in 2015. And it started out from a blog that I had run for about two years previously – called Orgcomplexity. I started trying to connect this whole idea of systems thinking, which came from general systems theory and systems biology – and also the world of physics with chaos and emergence and attractors. I worked very publicly through those ideas, which to some may be foolish because I was doing something that wasn’t within the norm. I was able to actually work out ideas, have people react to my ideas and work on this framework.
Is a systems approach always the best approach to public health?
Yes and no: it may surprise some who say: “well, isn’t everything complex?” And do we always look at it from that complex lens? We don’t always do that because it also depends on the question you’re asking. Some questions are best answered from a very linear reductionist standpoint: biostatistics measures for example. Those methods are appropriate for those questions. I am just asking that if the question is divergent in nature that we do not jump to using convergent solutions. We are all susceptible to mental models which is the first step for making sense of our world. Ecological framing is not new to public health and explains well the nested, concentric elements that make up health as we live it. Systems thinking calls us to rely on a more dynamic, time-based understanding of nested interdependent elemental systems when appropriate.
Why did you write a book, rather than publishing journal articles?
I chose not to do journal articles, because number one, I couldn’t get past the reviewers. Because they said: “well, we had other methods and those work, so why do something new?” And then because I wasn’t doing strictly analytical work, that would just get lost by the next journal article. I wanted there to be some type of salience, the ability for me to have a bigger footprint over a longer period of time. So I thought, “Okay, let’s be foolish and write a book”. And so that’s what I did. The second thing was that I was selected as a scholar at a place called the Hastings Center, which is located just north of New York City. And I was brought there as a specialist, as a visiting scholar. And I brought this really kooky idea saying that ethics are complex and they’re like “that is new”. And they just let me do it. That was the first time I felt freedom to actually push the envelope and try to do something that wasn’t expected.
Were there others working with this perspective?
I don’t want to say that there was nobody else in ethics doing this, but it wasn’t apparent to me that there was a large cluster who were using this perspective. Sometimes in academia, people follow each other like sheep. And I just decided to be a cow and not a sheep: I’m chewing cud and they’re just following each other – being herded. But in all fairness, I’m still in the academic world and to be published to have any success in that field. I certainly see the worth and the need for academia, but I also know that academics can be very smothering at times. Innovation is not something that they take to readily. So taking different perspectives just takes time, effort and patience. When you’re going up for tenure, there’s little room or time to be innovative. But I love what I do. I really cannot see myself doing anything else.Continue reading Better Know a Ronin Scholar: Michele Battle-Fisher