Dr. Bernard Choi, Public Health Agency of Canada

CARRFS eNews profiles Dr. Bernard Choi who has a Doctorate in Epidemiology from the University of Toronto and is Senior Research Scientist at the Public Health Agency of Canada.

First Published, March 2013

Dr. Bernard Choi, Senior Research Scientist at the Public Health Agency of Canada.

Dr. Bernard Choi, Senior Research Scientist at the Public Health Agency of Canada.

What is your background?

I had my first degree (BSc) in biochemistry in the faculty of science from Hong Kong. Then I went to England to get my second degree (MSc) in occupational health and safety in the faculty of engineering. My third degree (PhD) is in epidemiology from the faculty of medicine, University of Toronto. So my education has been from three different continents, three different faculties and three different disciplines. Prior to joining the Government of Canada, I was a professor of occupational and environmental health at the University of Toronto.

What is your position at the Public Health Agency of Canada and what do you spend the most time at in your job?

I am a Senior Research Scientist at the Public Health Agency of Canada. Senior researchers in the Agency serve three functions: 1. Provide research, development and analysis support to achieve the mission of the Public Health Agency of Canada, which is to “protect and promote the health and safety of all Canadians through leadership, partnership, innovation and action”; 2. Represent the Canadian Government and speak at national and international conferences and meetings; 3. Lead cross-cutting multi-disciplinary research teams. In my case these research teams are typically international. Additionally, I am also an adjunct professor at the University of Toronto, University of Ottawa, and the Shantou University in China.

What inspired you to go into the field of Epidemiology?

It was a series of random processes. After getting my degree in England, I was awarded an International Rotary Scholarship which specified that I had to do my PhD anywhere in the world but not the country I was residing in (England). Somehow I picked Canada–the first random process. To be on the safe side, I applied to several PhD programs at the University of Toronto. I was accepted by all of them–immunology, biochemistry, medical biophysics, microbiology and epidemiology. I had a hard time choosing one. On the final day of registration, I was somehow slightly more inclined towards epidemiology. In hindsight, I think I have made a very good choice–although random. In high school and university I did not like statistics and mathematics. In each of the courses with the name “bio”–like biology, biophysics, biochemistry, molecular biology–I got an A. I tried and successfully exempted myself from statistics courses throughout those years. The turning point came when I did my master thesis which involved microbiology laboratory work. As I was counting the number of bacterial colonies on petri plates, I had problem with the cut-off level at which to make decisions on the mutagenicity of industrial chemicals. This raised my interest in statistics, and to learn the basic principles of statistics.

You have just received the Gold Medal for Excellence in Public Service from the Professional Institute of the Public Service of Canada - what was their motivation to give you the Gold Medal?

According to the press release from the Professional Institute, they were very appreciative of my many years of research contributions to public health and especially public health surveillance. These are in terms of developing new methods and theories in public health surveillance, capacity enhancement, global health, knowledge transfer, and my extensive research in chronic diseases and risk factors. They liked my chronic disease clock. The clock was created to convey the impact and urgency of chronic disease on the health of Canadians. We set up the clock on the Agency’s website in 2004 and in the following year the US Centers for Disease Control and Prevention (CDC) set up the US clock. Two years later the Pan American Health Organization (PAHO) asked us to develop a clock for the WHO Region of the Americas. I think it is all these accumulated achievements that led to the award.

There are 60,000 government scientists in Canada working in the 13 federal government departments that involve research, as well as provincial/territorial governments and municipal/local governments. Each year the Professional Institute awards one Gold Medal. This year is the first year, since inception of the program in 1937, that the Gold Medal has been awarded to public health.

How do you think chronic disease surveillance can be improved in Canada and what methods do you think can be used to achieve it?

As in anything, if we want to improve, we need to look at the history and learn from it; assess the current situation; and then plan for the future. This is a lot of work but there is no shortcut. Late last year, I was invited to publish an article in the journal Scientifica called “The Past, Present and Future of Public Health Surveillance”. It is a literature review article and must exceed 10,000 words with over 200 references. The article outlines a number of insights in the literature on how to develop surveillance in the future. When it comes to methods to achieve these future goals, I think the mission statement of the Public Health Agency Canada can be a very good source of inspiration–leadership, partnership, innovation and action. In the near and long-term future we need to think about ways to promote leadership; partnership with various stakeholders; innovation–the CARRFS Surveillance Innovation Working Group can be instrumental here, and lastly action. I think surveillance should not stop at the dissemination of information to those who need to know. We need to do more than just providing information. We need to figure out how to strengthen the linkage of surveillance information to policy and program development, as well as evaluation.

With your tremendous international networking - how would you compare Canada with the best that is out there?

Over the years I have been working with a number of multidisciplinary networks and collaborative research teams. Compared to other countries, I would say Canada is doing very well in the area of public health surveillance. Canada is not facing the same issues as many other countries, e.g. those in Latin America where they operate with data that are 15-20 years out of date. In many countries, to avoid the huge staff and money resources to carry out a national health survey, the same "milestone" survey gets used year after year for making policy and program decisions.

On the other hand, Canada has things to learn from other countries. For example, we can learn from China and Jordan in how to conduct household face-to-face interviews. Many Latin American countries have become experts in cell phone surveys, as they have skipped the landline telephone stage and entered directly into the cell phone stage, and accumulated a lot of experience. We can learn about ways to boost survey response rates. China for example organizes publicized events such as lion dances when their national health surveys are launched. The PAHO wrote health songs on toxic effects of pesticides for radio broadcast, so farmers, who may not be able to read health reports and bar graphs, can sing along. This is just a few innovative examples that perhaps Canada can learn from other countries.

You were one of the founding members of the CARRFS - can you describe the status of the alliance and how you see CARRFS could evolve in the future?

I am pleased to report that 18 members who participated in the Think Tank Forum back in 2008 have now written and submitted a manuscript summarizing the findings of the Forum as well as commenting on the last four years of progress of chronic disease surveillance in Canada. Overall we are quite pleased with the progress and especially with the progress of CARRFS. At the same time we have identified a number of places where improvements can be made. We need to move things faster and get the consensus and collaboration of all CARRFS members in moving the surveillance agenda forward. In terms of the future, I think CARRFS is a living and breathing network, and therefore its future depends on the joint efforts of all CARRFS members. In that sense, I would like to thank all members of the Canadian Coordinating Committee and the members of the working groups of CARRFS in volunteering their time and making contributions to move CARRFS forward. <>

By Jostein Algroy