Professor James Smith is a Father Frank Flynn Fellow at Menzies with a focus on alcohol and other drugs harm minimisation.

In January 2020, Prof Smith and his family travelled to the United States of America (US) as the Northern Territory Fulbright Senior Scholar as part of the Fulbright Scholar Program, the flagship foreign exchange scholarship program of the USA, aimed at increasing binational collaboration, cultural understanding and the exchange of ideas.

Prof Smith spent four months between the Vanderbilt University Nashville, Tennessee and the University of Michigan in Ann Arbor, Michigan to identify promising health promotion strategies aimed at reducing health inequities among boys and young men of colour.

Prof Smith and his family have recently returned to Australia, currently undertaking a two-week quarantine in Brisbane before returning to the Northern Territory in late June.

Congratulations again on your Fulbright Scholarship. Tell us about the outcomes of your Fulbright experience?

The Fulbright experience was amazing. It provided a unique opportunity to stop, think and to reinvigorate my passion for promoting men’s health equity at a global scale. It has provided the necessary space to build positive relationships, networks and partnerships with individuals, organisations and institutions with a shared interest in reducing health and social inequities experienced by boys and young men of colour. It has paved the foundation for future collaborations in this space. Despite the impacts of COVID-19, and requirements to home quarantine, the Fulbright was still an extremely productive experience in many ways.

It seems the recent Black Lives Matter protests align with your Fulbright project. If so, in what ways?

Absolutely!!! A significant focus of my Fulbright project was looking at the health and social inequities that boys and young men of colour in the US experience on a daily basis. Early in my trip I got to visit the National Civil Rights Museum in Memphis. It blew me away. I had not realised how naïve I was in relation to socio-political elements of racism within the context of American history. I knew of the civil rights movement, but not in the way I do now. Fast forward 3½ months, and some of the key learnings are guiding current civil society action, in ways that mirror activism from decades ago. It makes me wonder how far we’ve still got to go to stop racism in both the US and Australia?

While the murder of George Floyd acted as a catalyst for civil society action in the form of protests and demonstrations associated with the Black Lives Matter movement, the reality is that the racial inequities that Black men face with respect to interactions with the police and the justice system is already well documented. Lack of action to address these inequities is what has been the problem.

What we have seen in both Australia and the US, is a deep awakening of these entrenched inequities. Millions of people have protested about racism in ways that have never before occurred in my lifetime. The protests occurred in every state across the US. They also extended into institutions. As an example, I observed strong student activism within the School of Social Work at University of Michigan (one of my host institutions), where over 250 students and faculty members participated in an online Town Hall meeting to discuss the (rightful) demands of Black students to strengthen anti-racism concepts within the curricula; and to stamp out White privilege and power at an institutional level. I truly hope that recent activism promotes positive societal change that conquers the structural and systemic racial inequities that Black people face - their lives DO MATTER!

At what stage of your time in the US did COVID-19 really hit?

President Trump gave an Oval Office address about the COVID-19 situation on 11 March 2020. That is when we realised the US was bracing for something big, amidst rhetoric that everything would be fine. Various restrictions followed shortly thereafter. By 13 March 2020 we were in full lock-down in Ann Arbor, Michigan. This was important as there had already been evidence of community spread in Detroit, only 45 minutes away from where we were staying. I was only a month in to my Fulbright at that stage and we had plans to travel the US and Canada post Fulbright, so we decided to stay. We also felt the risk of travelling back to Australia at that time would increase the likelihood of exposure to our family and the Australian community. We also had a safe place to bunker down. We were unaware that we would remain in lock-down until our departure on the last Virgin Australia repatriation flight on 7 June 2020.

What worried you most about the rapid spread of COVID-19 across the US?

It was evident very early on, particularly in conversations I was having with experts in minority health from across the US, that COVID-19 was disproportionately impacting people of colour and other marginalised and vulnerable populations. This was a deep concern. It was clear that people from low socio-economic backgrounds, racial minorities, homeless, people in prisons and those with disabilities were being hardest hit because of the health and social inequities they face. I was equally concerned for our Aboriginal and Torres Strait Islander communities back in Australia. What I observed in the US made me extremely appreciative of our universal health care system in Australia. The US reality is that access to health care is highly dependent on your level of health insurance. Many people can simply not afford this. I felt the most meaningful contribution I could make from the confines of home quarantine was to pen an editorial for Health Promotion Journal of Australia about COVID-19, vulnerability, and the power of privilege in a pandemic.

I felt raising awareness in this way was important. I have also used the Fulbright experience as opportunity to write a separate paper about COVID-19, equity and men’s health with colleagues from the US, the United Kingdom and Australia.

How did the whole Fulbright experience, including COVID-19, impact you and your your family?

It is really very difficult to put into words how the Fulbright has shaped my outlook on life. I travelled to the US with my family to have a once in a lifetime experience – and that is exactly what we had. Was it what we had expected? Absolutely not. It has been a melting pot of so many contrasting emotions – love and hate; trust and disbelief; compassion and indifference; warmth and coldness; fact and fiction.

At a professional level, it has exposed me to some of the brightest scholars I have ever met. It has nurtured and reinvigorated my interest in equity and men’s health, particularly those relating to intersections between gender, race and age. However, my Fulbright also coincided with one of the largest pandemics the world has ever seen – one where the nexus between health and the economy has challenged humanity in ways that are unprecedented. It also coincided with one of the largest global anti-racism activist efforts that I have ever experienced. These experiences provided the motivation I needed to remain productive during my Fulbright, but in ways that were different to what I had originally anticipated.

At a personal level, there is nothing quite like being locked in a house with a family of six for three months straight. The cultural experience of my four children attending a US public school only lasted 1½ weeks before home-schooling was required. The battle for one of the three computers was a daily fiasco. My kids (now aged 6, 7, 13 and 16) can be loud and boisterous at the best of times. However, the lock-down subdued us all. Indeed, I think COVID-19 slowed everyone down. In the context of our family, it forced us to form new bonds and get to know each other a little better. We cooked and ate in abundance; played cards and games; read books; did arts and crafts; over-indulged with television and movies; went for walks in the woods; and rested and slept lots. We also celebrated two family members' birthdays while in lock-down. It allowed us time to reflect on who and what is important is life. For this, I’m extremely grateful.

Where to from here?

I’m really keen to pursue more research in the area of equity and men’s health, particularly that relating to Indigenous male health; and social and emotional wellbeing. We are currently in the process of establishing the Northern Territory Division of the Freemasons Centre for Male Health and Wellbeing at Menzies, which will help me to achieve this goal. I’m confident that the Fulbright experience will help to foster international collaborations in this space.

We have also recently been awarded a men’s health promotion grant by the Australian Government Department of Health to develop online health resources to improve the health and wellbeing of young Aboriginal and Torres Strait Islander males. This project builds on the findings from a recent Lowitja Institute funded project about health literacy among young Aboriginal and Torres Strait Islander males in the NT.

How are you and your family keeping sane in quarantine? And will you have to quarantine again in Darwin?

We have just completed 14 days hotel quarantine in Brisbane and we coped OK as a family. We were in three separate rooms, with only one or two opportunities a day to connect face-to-face, during fresh air breaks. But we were all well looked after. 

Upon returning to Darwin will need to home quarantine for another 14 days. As frustrating as this is, it is important that we keep the Northern Territory safe from COVID-19. We need to play our part. We are, however, looking forward to returning to the glorious Darwin dry-season that awaits.

Key outputs of Prof Smith's Fulbright included:

  • 40+ interviews with key stakeholders from across the US (scholars, practitioners and policy-makers) with an interest in reducing health inequities among boys and young men of colour. 
  • The development and submission of three abstracts about equity and men's health that have all since been accepted for the American Public Health Association National Conference in October 2020 (to be presented virtually). 
  • Two editorials co-authored with his institutional hosts (Professor Derek Griffith and Professor Daphne Watkins) that relate to equity and men’s health. These have been published in the Health Promotion Journal of Australia and the American Journal of Men’s Health respectively:
  • An article submitted to the International Journal of Men’s Social and Community Health with colleagues from the UK and Australia, including Global Action on Men’s Health:
    • COVID-19, equity and men’s health: Using evidence to inform future public health policy, practice and research responses to pandemics. 
  • The submission of a book proposal to produce a co-edited book about health promotion strategies with boys and young men of colour. This reflects a major collaborative project with both of Prof Smith's Fulbright hosts. It also included the drafting of an introductory book chapter entitled ‘Towards a new understanding of health promotion with young men of colour’.
  • While at Vanderbilt University Prof Smith delivered two guest lectures for undergraduate students about men’s health literacy; and global men’s health policy.
  • While at the University of Michigan Prof Smith led the preparation and submission a collaborative small grant with Professor Daphne Watkins, Dr Zachary Jackson and Dr Lloyd Talley form the Curtis Center. The focus of the grant proposal is to adapt and trial an online education and support intervention modelled on the Young Black Men, Masculinities and Mental Health project (YBMen) with young Aboriginal and Torres Strait Islander males.
  • Prof Smith also delivered four public lectures via webinar for: Southern Plains Tribal Health Board, Oklahoma City, Oklahoma; Vivian A. & James L. Curtis Center for Health Equity Research and Training, School of Social Work, University of Michigan, Ann Arbor, Michigan; One-To-World, New York City, New York; and World Issues Forum, Fairhaven College of Interdisciplinary Studies, Western Washington University, Bellingham, Washington State.