Guest Lecturer Courtney Queen: Communities Thrive When They're Healthy

Courtney Queen is an Assistant Professor at the Department of Public Health at the Texas Tech University Health Sciences Center. She is a Fulbright Scholar to Rīga Stradiņš University (RSU) and will be teaching a seminar cycle on Health Equity from February to May 2022.

Read more about the cycle here

How did you find your way to RSU?

What was your impression?

I attended Research Week as a listener and was absolutely blown away by the quantity and quality of research happening at RSU.

I was also really impressed by the use of technology for presenting research and I found the approach to organising a conference very advanced and progressive. 
 
The poster presentations were well-organised and timed perfectly with the speakers. Of course, one of my greatest memories was getting to hear former President Vaira Vīķe-Freiberga speak! She is such an inspirational figure, especially as a female academic who is a prolific scholar and a public servant. It was an absolute honour to be there for her to speak about the integrity of science and research.

Why did you come here in 2000?

I was here in 2000-2002 as a volunteer for the Peace Corps. The Peace Corps started in 1991 and my group in 2002 was the last one. After this they cancelled the Peace Corps and EU and Nato came in instead. I lived in Rēzekne and Balvi and worked at the community level doing development work helping NGOs start up, develop strategic plans, think about the future, and write budgets. I was helping people write CVs for a new economy, a new society. I felt like I really got to qualitatively live at the community level getting to know people and their biographies and histories. That was really special to me. I think as I grew professionally and as an academic, I naturally retained those interests and relationships.

Tell me more about your field and how you found the specific questions that you're interested in?

I come from a background of history then naturally moved into sociology, public health, and medical sociology. The social, political, and economic determinants of health have always been a part of my professional career; questions that originate out of history and structural determinants of health outcomes. I've always been interested in how societies structure people's health, whether through policies, practice, or history.

How has your knowledge and experience of Latvia informed your career?

It had a huge impact! Americans have their own history of structuring opportunities for communities and populations.

Living in Latvia and getting to know Latvians definitely shaped my global view of how other societies and communities structure health outcomes for communities.

And they're different. Some predictors are pretty direct, like you have health insurance or you don't. It's a private opportunity that's really outdated. 

After I left Latvia I went to finish my doctorate, but I also worked in West Africa for a while. There I worked with neglected tropical diseases and in rural and remote communities that don't have the same access to healthcare that you do in urban areas.

What are some of the stereotypes and also misconceptions you've encountered about the US and European healthcare systems?

I encounter them all the time. You'll hear people say 'I don't want that system because they have to wait in line forever' about the systems in Europe, Canada, or the UK. Americans think that people can get denied access.

There are a lot of misconceptions because none of us know enough about other systems.

The history of how and why the US system developed in the way that it did is interesting and not that old. It was tied to your employment where the employer absorbs some of the cost, and then we just never updated that system. We never recognised that it needed changing because employment and society has changed, for example the emergence of the gig economy, or new ideas about what a traditional family is.

Overall I think you need to disentangle employment from access to healthcare. Communities thrive when they're healthy and communities need an equitable chance to be healthy.

How would you describe the Latvian system?

The Latvian system is different from the European system. You're in a transformational phase right now, because you used to have a fee-for-service model. This is not a great model considering health systems performance, but then you can't yet afford the full on European model.

The Latvian system is still relatively young. You're coming from a place where you're growing and financing and at the same time on a very macro level trying to have a healthy society that can pay taxes that can fund these different growth opportunities, right? Ideally Latvia will eventually adopt a system that works for everyone, but you have to kind of grow into that.

A lot of new independent healthcare systems start out as being fee-for-service, which is also what Latvia did. It's a terrible model and people can't afford it, but you have to start that way. If you have high poverty levels, people can't always afford the fee-for-service model, but at the same time public structures can't afford anything else either so these things just take time. 

What is it about your field that you want to impart through your seminars?

I hope to bring a perspective of cooperation, collaboration, and ideas for translational research to improve health. Moreover, I want to provide the tools and resources to think about doing this with a health equity framework. 

Screenshot from Queen's first seminar on 17 February 2022.

What is it you're getting in return or hoping to absorb while you're here?

I want to continue to enrich my experiences, soak up the history and build on the relationships that I have. I want to be able to continue to share this wonderful place with my family.

I'm excited to have my 7-year old daughter here with me. I want her to be able to know the wonderful people that live here, and I want her to learn Latvian. 

Professionally, I enjoy collaboration and I'm excited about the opportunities to develop and grow professionally with new models and research questions and new ideas. 

How has COVID-19 affected the way you work?

It doesn't bother me that much anymore, but we definitely don't get together like we used to.

Networking and informal connections and encounters are where the magic happens!

Maybe you drop your spoon during break at a conference and then all of a sudden you get to talk to someone new. Those little unexpected opportunities aren't there anymore, so a little bit of that magic is lost. I feel the loss in the research world, because so much of research is meeting people and hearing their ideas. You can overhear things casually that spark an idea in you and inspire you to take your research in a certain direction. You can meet someone and think 'oh I need your expertise or specific methodology'. I'm sad that this has been lost, but at the same time, everyone's in the same boat right now.