Title: NATIONAL SYMPOSIUM ON AGEING RESEARCH Canberra 24 September, 2003
1NATIONAL SYMPOSIUM ON AGEING RESEARCHCanberra24
September, 2003 Linking research, policy and
practice Michael MarmotInternational Centre
for Health and SocietyUCL
2TRANSLATING RESEARCH EVIDENCE INTO POLICY
3TRANSLATING RESEARCH EVIDENCE INTO POLICY
4All Cause Mortality by Grade of
Employment Whitehall Men 25 year Follow-up
Relative rate
40-64yrs 64-69yrs
70-89yrs
Marmot and Shipley, 1996
5- Independent Inquiry into
- Inequalities in Health
- REPORT
- CHAIRMAN SIR DONALD ACHESON
6 GENERAL RECOMMENDATIONS
- 1. Health Inequalities Impact Assessment All
policies to favour the less well-off. - 2. High priority to women of childbearing age,
expectant mothers and young children. - 3. Further steps to reduce income inequalities
and improve living standards of poor households.
Independent Inquiry into Inequalities in Health
7AREAS FOR FUTURE POLICY DEVELOPMENT (1)
- POVERTY INCOME
- HOUSING AND ENVIRONMENT
- EDUCATION
- MOBILITY, TRANSPORT, POLLUTION
- EMPLOYMENT
- NUTRITION
- NATIONAL HEALTH SERVICE
Independent Inquiry into Inequalities in Health
8AREAS FOR FUTURE POLICY DEVELOPMENT (2)
- MOTHERS AND FAMILIES
- OLDER PEOPLE
- ADULTS OF WORKING AGE
- GENDER
- ETHNICITY
Independent Inquiry into Inequalities in Health
9- Tackling Health Inequalities
- Summary of the 2002
- Cross-Cutting Review
- HM TREASURY
10National Targets for Tackling Health Inequalities
- Infant Mortality (Deaths in the first year of
life) Starting with children under one year, by
2010 to reduce by at least 10 the gap in
mortality between routine and manual groups and
the population as a whole - Expectation of Life Starting with local
authorities, by 2010 reduce by at least 10 the
gap between the fifth of areas with the lowest
life expectancy at birth and the population as a
whole.
11TRANSLATING RESEARCH EVIDENCE INTO POLICY
12STRATEGIES FOR BUILDING RESEARCH CAPACITY
13WHY DO WE NEED INTERDISCIPLINARY RESEARCH?
14Material factors
Social structure
Work
Brain Neuro- endocrine and immune
Psychological
Social Environment
Health Behaviours
Patho-physiological changes Organ impairment
Early Life
Well-being Mortality Morbidity
Genes
Culture
15- EPIDEMIOLOGY
- STATISTICS
- SOCIOLOGY
- SOCIAL PSYCHOLOGY
- PSYCHOBIOLOGY
- NEURENDOCRINOLOGY
- ECONOMICS
- MOLECULAR GENETICS
16FUNDING INTERDISCIPLINARY RESEARCH
17FUNDING INTERDISCIPLINARY RESEARCH?
18RESEARCH INTO AGEING
- Ageing as a lifelong process
- Needs of older people
19THE NATIONAL RESOURCE OF LARGE LONG-TERM COHORT
STUDIES
- has or is about to collect DNA
- ? data collection period
1946 cohort www.nshd.mrc.ac.uk 1958, 1970
Millennium cohorts www.cls.ioe.ac.uk ALSPAC
www.alspac.bristol.ac.uk ELSA Whitehall
www.ucl.ac.uk
20RESEARCH INTO AGEINGThe English Longitudinal
Study of Ageing(ELSA)
21The English Longitudinal Study of Ageing (ELSA)
- Research team
- International Centre for Health and Society, UCL
- Institute for Fiscal Studies and UCL
- National Centre for Social Research
- plus researchers from Cambridge, Oxford,
Nottingham - Funding from NIA and UK government
22Key Research Areas
- Health trajectories, disability and healthy life
expectancy - The relationship between economic position and
health - The determinants of economic position in older
age - The timing of retirement, and post retirement
labour market activity - The nature of social networks, support and
participation - Household and family structure, and the transfer
of resources
23Broad questionnaire coverage
- Demographics
- Health
- Social participation
- Housing
- Employment and earnings
- Pensions and retirement
24Broad questionnaire coverage (cont)
- Income and assets
- Cognitive function
- Psychosocial
- Expectations
- Measurements
- Self completion (social support, GHQ12, Beck
depression inventory)
25Collaboration with UK panel studies
- 1946 birth cohort
- Whitehall II
- Testing of explanations for inequalities in
health - Cohort growing older and retiring
26Collaboration with UK panel studies
- 1946 birth cohort
- Whitehall II
- BHPS
- Full age cross-section
- Focus on older people in 2002 wave
- Sharing of topics and measures
27Comparative issues
- Ex-ante policy evaluation difficult
- Understanding causal relationships difficult
- Comparative data can
- Help understand differences between countries
- Expand sources of variation available to
researchers (conditional on enough observables to
make the comparison valid) - Help examine role of institutions directly
- Principal international comparators Health and
Retirement Study (HRS), SHARE
28ELSA will look quite like HRS
- Two-yearly frequency
- Exit interview (post mortality, with proxy)
- Modular structure core content
- Unfolding brackets
- Financial respondent
- Expectations
- But with some differences
- biomedical health data
- cognitive function
- psychosocial factors
- Face to face waves 1 and 2 (plus nurse visit wave
2)
29FUTURE DIRECTIONS FOR AUSTRALIA?