Public health research literatures

1
Public health research literatures their
coverage and gaps in Europe
Measuring European public health research what
does the literature show? A SPHERE (Strengthening
Public Health Research in Europe) workshop EUPHA
conference, Montreux Thursday 16th November
2006 15.30 17.00
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Public health research literatures their
coverage and gaps in Europe
Methodology

• Public Health Research definition for study
• populations
• health
• determinants/context (genetic, environmental,
  social)
• interventions to improve health and reduce
  inequalities
• designed to produce generalisable knowledge
  rather than specific programmes of service
  delivery

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Public health research literatures their
coverage and gaps in Europe
Methodology

• Definition of topic area and relationship to
  Public Health research
• Framework including list of sub-topics
• Search strategy/filter to interrogate electronic
  databases to include
• all of EEA
• ten years 01.07.95 - 30.06.05
• peer-reviewed published research only
• original research only
• exclude
• grey literature
• purely descriptive research

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Public health research literatures their
coverage and gaps in Europe
Methodology

• Presentation of results to include
• numbers of publications/papers/references by key
  words and by country
• assessment by denominators
• 1000s population
• GDP
• burden of disease measured in DALYs

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Public health research literatures their
coverage and gaps in Europe
English literature overview results

• 210,433 publications found. Precision and recall
  0.61 and 0.68 respectively
• EEA extremely important producer of public health
  research - an annual average 6862 (32,3)
  compared to 9422 (44), for the United States
• variations in output within the EEA. UK and
  Nordic countries relatively high producers
• GDP - overall strongest predictor of public
  health research
• Collaboration - smaller countries, lower
  producers collaborate more (Lithuania, Latvia,
  Portugal). UK and Finland collaborate less

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Public health research literatures their
coverage and gaps in Europe
English literature overview conclusions

• relative under-investment in public health
  research by many European countries including
  France, Greece, Spain, Italy, Portugal, Germany,
  and many Eastern European countries, compared to
  the US and the UK
• We recommend
• investigation of relative spend on public health
  research as a proportion of each countrys
  research expenditure
• assessment of relevance of public health research
  against health need

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Public health research literatures their
coverage and gaps in Europe
French PH journals methods results

• 4000 ref from 7 PH journals indexed according
  to burden of diseases and to PH functions
•  Infectious diseases, perinatal and nutritional
  conditions  category received high level of
  attention, compared with  chronic diseases  and
   injuries 
•  Monitoring  is the most frequent function,
  followed by  health services research 
•  Prevention  represents only 7 (14 at most)
  compared with 17 in a Canadian journal

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Public health research literatures their
coverage and gaps in Europe
French PH journals conclusions

• The focus of papers in French public health
  journals may reflect historical domains and data
  availability
• The relatively low proportion of papers focusing
  on prevention raises questions about funding and
  academic involvement in this field
• Research following comparable objectives but
  based on overall scientific public health
  research would be useful

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Public health research literatures their
coverage and gaps in Europe
Environmental Health Research (1)

• Environmental health research is
• carried out by a large number of
• research centres in EEA countries.
• 6329 references have been
• retrieved for the period 1995-2005
• there are marked differences in the
• research potential between
• countries
• five top countries contributed 55
• of all retrieved papers and ten top
• countries 81

Public health research literatures
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Public health research literatures their
coverage and gaps in Europe
Environmental Health Research (2)

• Main research focus
• EEA countries have the same priority focus in
  environmental health research.
• 73 of the research effort concentrates on
• three areas occupational health, environmental
  exposures and environmental illnesses.
• Envirogenomics opens new opportunities
• to enhance the understanding environmental
  etiology of diseases. Publication output in EEA
  is four times less than in USA only.
• Public health policy increasingly needs to be
  based on concepts of multicausality and
• complexity.

Public health research literatures
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Public health research literatures their
coverage and gaps in Europe
Genetic Epidemiology research results
Research areas on genetic epidemiology in Europe
and in the USA based on papers published between
1987-2004
EUROPE, n160
USA, n201
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Public health research literatures their
coverage and gaps in Europe
Genetic Epidemiology research conclusions

• growing PH importance of risk assessment
• genetic epidemiology research ? genomics research
• array techniques
• research going to be shifted to clinical
  implication
• gene therapy
• more supportive policy needed towards EU10 and
  non-EU countries
• PH network needs to be facilitated

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Public health research literatures their
coverage and gaps in Europe
Health promotion research results

• lt7000 HP research publications found
• Strong relationship between HP publications and
  GDP
• 27 related to immunisation and screening
• In the remaining 73
• Focus on individual level interventions
• Focus on diet and physical activity, tobacco use
  and cardiovascular disease
• Very little on mental health, alcohol reduction
  or accidents and violence

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Public health research literatures their
coverage and gaps in Europe
Health promotion research conclusions

• Need for targeted research commissioning
• national and policy levels as opposed to
  individual /local levels
• wider range of topics, particularly
• accidents and violence
• alcohol use reduction
• mental health promotion

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Health services research (1)
Public health research literatures their
coverage and gaps in Europe

• Health services research is
• A large and growing domain of research (over
  30,000 publications found)
• HSR is strongly developed in the Nordic
  countries, Estonia, Ireland, the United Kindom,
  the Netherlands
• Topics addressed follow political agendas /
  health system characteristics.

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Health services research (2)
Public health research literatures their
coverage and gaps in Europe

• Problems addressed in HSR are
• Efficiency of health services and quality
  improvement (56)
• ? doing things right
• Organisation of care, cohesion between parts of
  the systems, and arrangement of services (27)
• ? doing the right things
• Inequalities in health care utilization and
  distribution of services of the population/
  country (10)
• ? for the right people.

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Public health research literatures their
coverage and gaps in Europe
Infectious Diseases research results

• MAIN TOPIC (whole of Infectious Diseases)
• 1201 articles found France, Germany, Italy,
  Netherlands, Spain, Sweden, Switzerland and UK
  most prolific actors
• by 1000 population Denmark, Luxemburg,
  Netherlands, Sweden Switzerland most productive
• by GDP Estonia, Hungary, Lithuania, Netherlands,
  Slovakia, Slovenia, Sweden Switzerland most
  productive
• SUBTOPICS (from Centre for Diseases Control and
  Prevention classification)
• 9321 published papers found, significantly higher
  than for main topic areas (paradoxical result)
• Main fields STDs, Drug Resistant Infections,
  Emerging Infectious Diseases and Insects or
  Arthropod-Related Diseases
• 4613 papers on subtopic STDs
• MAIN DISEASES and NEW SUBTOPICS
• 4922 articles on HIV
• 6243 papers on Vaccine preventable Diseases

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Public health research literatures their
coverage and gaps in Europe
Infectious Diseases Research Conclusions

• Literature production shows a progressive
  increase
• Wide heterogeneity concerning overall scientific
  production on IDs in Europe
• Sexually Transmitted Diseases, Drug Resistant
  Infections, Emerging Infectious Diseases, Insects
  or Arthropod-Related Diseases Vaccine are the
  main fields of scientific research
• Research on subtopics Bioterrorism, Occupational
  Risk in Healthcare Food related Diseases needs
  to be significantly improved
• First priority to cooperate to help States with
  no scientific production and harmonize research
  in Europe
• Need for further studies to better focus the real
  state of the art of the research on IDs in EU,
  with a more analytic approach

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Health Management Research Results
Public health research literatures their
coverage and gaps in Europe

• Public health management not a well defined
  discipline its focus is broad and on health
  improvement not to be confused with health
  services research
• 1,047 journal articles initially selected from
  which 63 were identified as relevant
• Strong relationship between health management
  research publications and GDP with heavy bias
  towards UK
• Majority of articles focus on chronic
  disease/long term conditions management
• Very few focus on mainstream management issues
  affecting the publics health

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Public health research literatures their
coverage and gaps in Europe
Health Management Research Conclusions

• There exists a paucity of public health
  management research aimed at strengthening the
  evidence base for effective interventions
• There is a lack of research capacity in public
  health management as a result of underinvestment
  and weak infrastructure
• More support is needed to foster
  multidisciplinary research links
• More research needed on partnerships,
  cross-sectoral working, governance, change
  management, leadership
• Health management is an underdeveloped research
  area throughout Europe

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Public health research literatures their
coverage and gaps in Europe
Common Themes

• The EEA is an important producer of public health
  research
• Public health research does not appear to
• Be proportionate to health needs at a
  geographical level
• focus on important health needs at the health
  topic level
• focus on inequalities
• afford enough prominence to an active
• interventional approach

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Public health research literatures their
coverage and gaps in Europe
Next stage recommendations

• Achieve a more informed picture of the realities
  and challenges facing public health researchers
  by surveying and/or interviewing researchers
  across Europe
• Evidence-based research commissioning - with a
  greater stress on interventional research on a
  wider range of topics, more related to health
  need
•  
• More emphasis in research on higher (national
  policy) levels, less on the individual
•  
• Research into GAPS in understanding of and
  response to health needs, and the ability to
  tackle inequalities for each country
•  
• Consideration of the generalisability of already
  available research

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EUPHA Workshop Germany
EUPHA Conference Helsinki
EUPHA Conference Montreux
Study Set up
Literature
Consultation
PRELIMINARY ASSESSMENT
REVIEWS
FINAL REPORT
Strategy

• Stakeholders
• European public health science and policy
  communities
• National and European political and
  administrative organisations
• International scientific bodies and institutions

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