A diversity of perspectives, particularly from those with lived experiences of poverty and socio-economic disadvantage, is critical to strengthening public health research, policy and practice. In today’s analysis, Joelie Mandzufas (@jmzuf7) PhD candidate at Telethon Kids Institute (@telethonkids) and The University of Western Australia (@uwanews) highlights the need for complex social problems to be addressed ‘from the inside out’.

I looked around our team one day and realised many of us had started our research careers by volunteering. When I pondered this further, I realised that we mostly came from backgrounds that allowed us to give some time to unpaid roles.

Much of the research conducted at Telethon Kids Institute investigates ways to make life better for kids who live with, and are growing up in, disadvantage. But many researchers have limited lived experience of this to draw on.

So, how can we ensure we include the first-person perspective of people with lived experiences of disadvantage in the public health workforce?

A foot in the door

Understanding how wicked problems impact on people requires deliberate and wide-ranging strategies to elevate their expertise and knowledge. Photo by **Faisal Rahman** from **Pexels**

Many university courses in Australia offer students workplace experience through workplace-integrated learning or ‘pracs’ as part of their degree.

Students or recent graduates who are looking to secure full-time paid positions will often seek out further opportunities to gain more practical experience, again typically on a voluntary basis.

However, socio-economically disadvantaged students or graduates may not have the resources, including family supports, to enable them to access volunteering or other unpaid work experience opportunities.

It is more likely that they will be supporting themselves, and perhaps a family, so will need to source paid employment, even if this work experience is not directly related to their studies.

As graduates, they are therefore at a distinct disadvantage in the recruitment process, when competing against graduates whose structural supports have allowed them to gain directly relevant yet unpaid work experience.

To encourage more equitable capacity building, we must support the development of disadvantaged students and graduates into competitive job applicants.

Government financial supports to assist with living expenses could be extended to those gaining practical unpaid work experience, for example subsidies for childcare, transport, or equipment.

Paid internships, whether sponsored by industry, philanthropy, or government, also give disadvantaged students or graduates a ‘foot in the door’ without the financial stress associated with unpaid positions. The experience gained via internships matches or exceeds that of unpaid volunteering experience, providing a valuable boost to the resumes of those living with disadvantage and increasing their visibility in the recruitment process.

Lived experiences

To complement this approach, lived experience should also be encouraged on applications for graduate positions and attract the same weighting as work experience.

Public health researchers and practitioners are tasked with addressing wicked problems such as poverty with multiple determinants and no obvious or easy solutions.

To better understand the complex nature of these problems, we need to explore diverse perspectives, including from those with lived experience of the issues under examination.

While it is not unusual to include the voices of people with lived experience whilst engaging in community consultation and co-design to work towards practical improvements, it is important that the perspective of the lived experience is also embedded in the paid workforce.

The public health workforce can look to the community services sector as an exemplar: the deep connection to, and understanding of, the diverse life experiences of workers (such as alcohol and drug use, or mental health problems) are very highly valued.

In the same way, the public health workforce would greatly benefit by honouring the unique view ‘from the inside out’.

Children’s voices

Valuing those with a lived experience of disadvantage in the public health workforce will facilitate more meaningful engagement with disadvantaged communities, including with children growing up in poverty and disadvantage.

The impact of poverty in childhood, as highlighted in our recent Life Course Centre Working Paper, can negatively impact children’s development, health and educational success.

When poverty is experienced at a very young age the short- and long-term effects can be greater, owing to rapid brain development. Therefore, it is critical to provide good evidence for early childhood investment policy decisions.

When investigating ways to assist vulnerable children and families, we must not overlook the voices of children themselves. Even at a young age, children are aware of poverty and social class issues, and the stigma associated with being labelled ‘poor’.

In another recent Life Course Centre Working Paper, children’s own stories about their poverty experiences reveal the extent of the negative impact on their wellbeing. Many children are sad, angry or frustrated, but they also express concern for their parents and for the family’s financial situation.

Children’s distress can be related to unsafe or insecure housing, family conflict, feeling unsafe in their neighbourhood, or not having essential school items or clothing, or missing school trips. Some children don’t have much hope for a bright future or aspire to a ‘better’ life.

There are social costs of poverty too – these can include difficulties making and keeping friends, experiences with bullying, and exclusion from social or leisure activities.

However, children show a remarkable range of coping strategies, and we can also build parents’ skills to help protect their children from the effects of poverty.

Research to better understand the lived experience of poverty for children will help build an evidence base detailing the supports needed and wanted by families. This will enable the co-development of initiatives to better meet these needs.

The complexity of many of the ‘wicked problems’ that we in public health are trying to understand requires a whole-of-system approach. Lived experience is essential to this process. Broadening our inclusion of lived experience requires creating pathways into research and practice, acknowledging the value of lived experience, and finding better ways to hear from children.

This post is part of the Women's Policy Action Tank initiative to analyse government policy using a gendered lens. View our other policy analysis pieces here.

Posted by @LifeCourseAust

Tackling wicked problems from the inside out