Lost in translation…

Just before Christmas I attended Academy Health’s 8th Annual Conference in Washington. Whilst there, I took the chance to do a bit of sight-seeing and meet new people. I usually clutch a dog-eared language guide on trips overseas, but as this was the USA, and I’ve spoken English all my life, I didn’t bother to take one with me. However, I was rarely understood initially, and in restaurants it took four or five attempts. So, ignoring cringes all round, I attempted an American accent and thought about the context before speaking. 

The conference itself was a good opportunity to reflect on the differences between how language is used in the policy and research worlds. Having worked in nine government departments, over twenty five years, I had always assumed that language was an unlikely reason for research not being used systematically in policy development, but it seems that might not be so. Like the subtle language barrier between the British and Americans, a similar one exists between researchers and policymakers. We come at similar issues in different ways, from different perspectives, and place emphasis on different things.

Once home, one of my research colleagues shared Christopher JM Whitty’s very readable piece on ‘What makes an academic paper useful for health policy?’ Whitty talks about barriers to evidence-based policy in terms of a lack of available evidence; a lack of demand by policymakers; and, academics not producing papers within the time frame of the policy cycle. His paper concentrates on the last point, and whilst I recognise much of what he says, I wonder if another barrier could be language? 

Two of the conference sessions addressed this, Ambassador Deborah L Birx, MD, the US Global AIDS Coordinator and US Special Representative for Global Health Diplomacy, on Building a Worldwide Evidence Base; and Professor Jonathan Purtle of Drexel University on the use of research evidence among state legislators who prioritize mental health and substance abuse issues.

The first session struck a chord because the Ambassador understood the language used by policy officials. She talked about how she had adapted her presentations to policy officials, who then changed their approach to better tackle HIV across the globe. Professor Purtle also spoke to health policymakers in our language. His presentation focused on what matters to us, recognising that policy officials have little time to dwell on the methods used – we generally trust research colleagues’ competence and reputation in these areas – and instead concentrated on the ’so whats’. Both speakers asked for changes in the way we talk to each other. I supported Professor Purtle’s points about language and emphasis, acknowledging it’s a two-way challenge.

But does it matter? We all use language that our communities are comfortable with. The policy community uses language that is impenetrable to others, and we should be more considerate. But language gives us a sense of loyalty esprit de corps, and makes us feel special. It can also be isolating. I still remember my feelings of dismay on my first day in Whitehall. I had joined having come from public services, working with the public, where I had needed to use clear and unambiguous language..  So, picking up my first piece of Ministerial correspondence to answer, I struggled to decode the helpful annotation, ‘This is a round robin.  Treat with a straight bat’. I almost turned on my heel and walked out, but had I done so I would have missed out on twenty years of interesting and worthwhile policy work at the heart of government. Similarly, if we fail to address the differences in language and approach in policy and research we will continue to miss the importance and relevance of each others’ work. So yes, it does matter. 

What to do next? I know there are many research colleagues who also believe that language matters. Chatting with a colleague at the end of the conference we agreed that it would be helpful if policymakers were to tell researchers what we do with research, a version of ‘here’s what I heard from you, but this is what I wanted’, and for researchers to tell policymakers, ’this is what you wanted, but this is what you needed’. I told her about the work I am leading in the Health Foundation to help build policy-making capability and we talked about making a film to address these questions and share among our respective communities – much to the hilarity of my fellow policy colleagues who through tears of laughter started talking about ‘Ruth: the movie’. Perhaps a better title would be ’Lost in translation’, but sadly that’s already taken...

Ruth Knox is a Senior Policy Fellow at the Health Foundation