Children, young people & families programme, Health inequalities theme, Efficient and equitable health systems
University of Liverpool (LiLaC)
Hear more about Courtney's research
What has been your career journey so far?
I graduated from the University of Liverpool in BSc Mathematics. During my time studying in Liverpool, I became widely interested in using my skills within Public Health. During my summer break, I volunteered as a research assistant at Imperial College National Heart & Lung Institute and later became co-author of a paper on the burden of preschool wheeze and progression to school age asthma. I fell in love with my newfound application for Maths and studied a module in Medical statistics, further choosing to complete an optional dissertation on the creation of a new model to predict child mortality in ICU. I then decided to continue my journey and studied MSc Medical Statistics at the London School of Hygiene and Tropical Medicine. When the pandemic hit, and I was unable to complete my studies in London, I knew returning to Liverpool was my ideal goal and I hoped for another opportunity to use my skills within research. Now back at the University of Liverpool, and with the SPHR and ARC NWC, I’m able to work towards the goal of a doctorate and work in Public Health research, where I can apply my education in a sector that has the opportunity to help large populations.
Why did you choose to do a PhD in public health research?
Despite the stereotype of Mathematicians starting careers in banking or actuary, I’ve always wanted to apply my computational skills in a job that can help benefit large populations. As a Maths enthusiast, I’m eager to prove computational skills don’t just mean you’re confined to a desk job crunching numbers, and instead, there are huge possibilities in a choice of career. Throughout my lifetime, my mum has been unfortunate enough to battle several life-threatening illnesses. She has battled cancer, kidney failure, a pulmonary embolism, transient ischaemic attacks and, believe it or not, the list goes on. Yet, despite all this, the outstanding work from all her nurses, doctors and pharmacists have allowed her the best possible care and quality of life. Seeing first-hand the incredible work of our NHS, I knew it was my duty to use my education for good. Further, it made me think about the substantial amount of ‘behind the scenes’ research that had been done in order to better inform the care of a patient such as my mum. Behind those on the front line, must also have been a long list of researchers looking at the best possible medication, treatment plan, equitable access to healthcare etc. The list could go on. Since then, the road to public health research has always seemed the natural route to take, and I haven’t looked back. Not only does a PhD in public health allow me to build upon the computational skills I already have, but I now have an amazing opportunity to learn skills in qualitative research methods, working with a multidisciplinary team, working with the public and in an exciting environment where your work has the capacity to help so many people.
What is your research focused on?
My research looks at inequalities associated with febrile illness (fever) and emergency department (ED) attendance in children. ED attendances continue to rise nationally, and this increase has been markedly dramatic in disadvantaged cities such as Liverpool. Liverpool has higher than national average population of children from the most deprived backgrounds, with approximately 28% of children in low income families, and these children are more likely to present to the ED with a febrile illness. Despite evidence to show an association between infectious diseases and disadvantaged socioeconomic conditions (SECs), it is unclear what is driving the current increase in ED use for febrile illness. This may plausibly reflect increased incidence of disease, greater unmet healthcare need, or a lack of access and use of appropriate primary care services. A report forecasting the future burdens in paediatric health care has predicted a ‘significant decline’ in the global burden of infections. However, it is expected that with worsening poverty and the widening gap in health inequalities, challenges in child health will continue to rise and with it, the number of children requiring care in an ED. It is also unclear whether the views of parents presenting to the ED with an unwell child, and the views of healthcare professionals influence the clinical management of febrile children, and whether childhood SECs influence whether tests are performed, and whether antibiotics are administered. Using a mixed methods approach, this research seeks to explore these factors in greater detail.
Why is it important?
The research will provide evidence to ensure that already disadvantaged children with febrile illness are not further disadvantaged by existing care pathways. Despite the existence and persistence of these health inequalities, they are not inevitable and can be avoided. Therefore, expanding the evidence base of inequalities in childhood febrile illness associated with paediatric ED attendance is essential in informing policy makers to reduce health inequalities that are both unjust and preventable. The knowledge generated within this thesis will not only provide a better picture of the health inequalities associated with paediatric febrile illness in Liverpool, but it also has the capacity to better inform us of the possible inequalities in the care pathway for febrile illness in children nationwide as findings could be generalised across the UK.
What do you like about being part of a NIHR SPHR and ARC collaboration?
Being part of this collaboration allows a much wider network of like-minded people, allowing me to be immersed in a wider community. Not only is it important to share knowledge and have the opportunity to discuss our own research as well as hear of other’s research, but in the current climate, starting a PhD in the UK lockdown was extremely difficult. Being connected to a wider community has allowed me to meet so many people I otherwise would not have been able to. Sharing knowledge and skills has been invaluable at the start of my research career.
What skills are hoping to learn as part of your PhD?
The biggest attraction of a PhD was the large range of skills you can acquire. Coming from a largely computational background, I now have the opportunity to perform a mixed-methods study, allowing me to delve into the new world of qualitative research. Not only does a PhD provide access to a wealth of new research methods and study designs, but, arguably more importantly, it has given me the opportunity to present and discuss my research in an academic setting. Near the start of my PhD, I was told “a PhD isn’t just your thesis. A PhD is you as a researcher” and this couldn’t be more true. Not only can I learn new methods and skills applicable for my research, but the process of a PhD will provide me with invaluable personal skills that I can take forward into my career.
What do you hope to do after completing your PhD?
My hope would be to continue with research in public health. The biggest attraction for me was that, working in public health could lead to research in so many topics. Not knowing where my interests could take me next is really exciting.