How age, gender, and caregiving affect your health
Dr. Susan Phillips, a Professor in Family Medicine and Public Health Sciences, has noticed throughout her career that there can sometimes be a major discrepancy between how patients say they feel and how she would assume they’d feel based on their physical health.
“I have had patients who have several serious or even life-threatening illnesses come see me,” she says, “and when I ask how they’re doing they say ‘I’m doing really well.’” Dr. Phillips says she has always been interested in counterintuitive findings like this, where the wellbeing of patients seems to run counter to what one would predict. These patients – the ones who seem to feel fine despite their conditions – raise a number of questions that she has wanted to explore about the range of factors that determine a patient’s wellness. “People are not just their conditions,” Dr. Phillips says, “diabetics, for instance, are not defined by diabetes alone, if they are defined by it at all.” But she believes that medicine and research do not currently have sophisticated ways of addressing this phenomenon, which she refers to as "how the outside world gets under the skin".
Now, Dr. Phillips is the Canadian PI on a study that aims to provide a more robust understanding of how health is connected to a range of social factors, especially age, gender, and caregiving. The project is called FUTUREGEN, and it is a collaboration between Dr. Phillips and researchers in Sweden and Austria. Starting on March 1, FUTUREGEN will receive $1.3 million in funding from GENDER-NET Plus, an international consortium of sixteen research funders in thirteen countries. The funding for FUTUREGEN will come from the Canadian Institutes of Health Research (CIHR) as well as funding agencies in the European Union.
This project will bring together researchers with a range of academic expertise to explore these complex questions about health; Dr. Phillips is the only physician among the three principal investigators, as the other two are a social worker and an economist respectively. Dr. Janet Jull, an Assistant Professor in the Queen’s School of Rehabilitation Therapy, will also serve as a co-Investigator on the project. Dr. Phillips believes that this diversity of perspectives will enrich both the conceptualization and the interpretation of the research.
Work on FUTUREGEN will begin in March, and the researchers will start by examining datasets from all three countries to figure out what circumstances are having the most impact on people’s health, especially as they age. Dr. Phillips says that these datasets are so large that her research team will be able to make and compare highly refined categories. The dataset from the Canadian Longitudinal Study on Aging, for instance, has medical and demographic data from over 58,000 people over the age of 50. With such a substantial database, Dr. Phillips and her colleagues will be able to examine how factors, such as gender, location or income, affect the health of people in different age ranges. By looking at an array of different variables, Dr. Phillips aims to be able to explain what predicts different health outcomes for different people.
Currently, Dr. Phillips is preparing for this work by considering the methodology that she will use to study these large datasets. She wants to make sure that she employs a sophisticated approach to examining the intersections of and interactions among the social circumstances that influence health. By being reflective about her methods, Dr. Phillips hopes that she can create useful categories for understanding health outcomes that avoid the pitfalls of both assuming similarities within groups and of overgeneralization.
Dr. Phillips’s ultimate goal for FUTUREGEN is to use findings to better inform health and social policies at the provincial and national levels. While working on the project, then, the research team will meet regularly with a specific group of policy experts who will reflect upon and challenge their findings and determine how their work could be useful to policy makers. Given the scope of FUTUREGEN, there is a real potential for this work to help the Canadian health care system use new methods to promote healthy aging for people across our society, and Dr. Phillips is eager to realize that potential.
Dr. Phillips sees this new project as building on the work that she previously did on the CIHR-funded International Mobility in Aging Study. In that study the evidence that people are often less concerned about the specifics of a medical diagnosis than they are about the practical effects those conditions will have on their daily lives and function first emerged. Many of the questions that Dr. Phillips hopes to answer with FUTUREGEN were inspired by these initial findings about self-defined successful aging.
Seeing the way that, for Dr. Phillips, one large research project opens up complex questions to explore in a subsequent project, it is clear to me that she has the keen and unfailing sense of curiosity that all the best researchers possess. That makes it especially interesting to me that she says she never intended to have a career in research when she was studying to become a physician. “I never set out to be a researcher,” she told me. “I set out to be a good family doctor.” Yet, as she kept finding herself asking questions that had no readily available answer, research gradually became more important to her.
Now, Dr. Phillips has a number of significant publications and grants, and she has been awarded with a Lifetime Achievement in Family Medicine Research Award from the College of Family Physicians of Canada.
Even with all this research success, though, Dr. Phillips says she is still primarily motivated by her patients. She decided to join FUTUREGEN because she wants to find ways to better understand what influences their health and how to help them age well.
“Everything for me,” she says, “starts with and comes back to being a family physician.”
How do you think your health has been affected by social circumstances? Please share your thoughts in the comments below, or, better yet, please stop by the Macklem House: my door is always open.
I would like to thank Andrew Willson for his assistance in preparing this blog.