Plotting new pathways to health
Certain sections of society suffer from poorer health than others. An EU-funded project based in Dublin is analysing multiple types of data to determine which factors most influence health and how new policies can help to reduce 'health inequalities'.
© Darren Baker fotolia
Typically, inequalities in health emerge very early in life and persist unless there is some intervention or programme provided to reduce them.
The aim of the Devhealth project Understanding health across the lifecourse: An integrated developmental approach is to understand what causes health inequalities over people’s lifetime and across generations and how they can be rectified. In particular, the project is looking at the individual and environmental characteristics, such as our genes, personality, behaviour, etc. which may affect health outcomes. The project is led by Prof. James Heckman, an American Nobel Prize-winning economist from the University of Chicago. He and his team are carrying out the research project at University College Dublin (UCD) in Ireland.
“Devhealth examines how our health is influenced by our cognitive skills, such as our IQ and mental capacities, as well as our socio-emotional and behavioural skills, like our personality traits and social skills,” says Dr Orla Doyle, research fellow at UCD’s Geary Institute and a member of Prof. Heckman’s team. She is the project leader for one of Devhealth’s research areas focusing on the health benefits of early childhood interventions.
“While we have a certain degree of control over our health through our ‘health behaviours’, our health is also influenced by our genes and our early life environment. Although our genetic inheritance is fixed, the environment can influence how our genes are expressed,” Dr Doyle explains.
Devhealth explores these mechanisms and examines how changing the early life environment impacts on gene expression. By understanding the factors that influence health outcomes and then testing the effectiveness of different interventions and policies which target these factors, the project will formulate policy recommendations about how best to substantially reduce health inequalities.
Shooting for Europe’s health targets
Devhealth’s target is to improve lifecycle health care from the cradle to the grave for future generations of Europeans.
The project, supported by an Advanced Grant from the ERC, is in line with the EU’s objective of advancing the state of the art in the field of health promotion and primary prevention research.
Devhealth’s research is aimed at improving the health cycle of Europe’s future society and employment base. By analysing factors which can adversely affect health and intervention programmes that can provide better prevention and care, the researchers are working to secure a healthier and more prosperous future for Europe.
The project team is analysing a number of major international datasets looking into the factors influencing health over a person’s lifetime. One of the main datasets being used is the National Child Development Study (NCDS) which follows the lives of over 18 000 children who were born in the UK during one week in March 1958. This dataset contains information on education, cognitive ability, social skills, personality traits, physical and mental health, income, marital status and criminal activity.
Another database includes information that was collected from the 1960s onwards from children who participated in different early childhood programmes in the US and Ireland, such as the Perry Preschool Program and the Nurse Family Partnership programme.
This data shows the long-term impact of childhood development, parenting and health programmes – which specifically targeted disadvantaged families – on children’s health later in life. It also examines how the programmes changed the children’s cognitive, social, emotional and behavioural skills and how, in turn, these affected their health.
Past, present and future
Devhealth is not only using historical studies but is also evaluating the effectiveness of new early childhood programmes which are currently running in Ireland.
“The data is being used to measure the extent of health disparities for different health outcomes and whether these disparities differ at different stages of life, and to examine the individual and environmental factors that affect health disparities”, Dr Doyle explains. These results are then used to examine whether targeted early childhood interventions can be effective at reducing health disparities.
One of the objectives is to create a practical guide to implement policy to reduce health disparities. It will identify which factors, among all those being analysed, most influence health and cause health inequalities, and which are most amenable to change. The guide is aimed at policy-makers in education, health and social policy, practitioners working in the health services, education and social services, as well as peer academics.
“Through this guide, Devhealth will provide new information on which factors play the greatest role in influencing health outcomes, and which of these factors can be best affected by policy,” concludes Dr Doyle.