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NATIONAL SYMPOSIUM ON AGEING RESEARCH Canberra 24 September, 2003 “Linking research, policy and practice” Michael Marmot International Centre for Health.

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Presentation on theme: "NATIONAL SYMPOSIUM ON AGEING RESEARCH Canberra 24 September, 2003 “Linking research, policy and practice” Michael Marmot International Centre for Health."— Presentation transcript:

1 NATIONAL SYMPOSIUM ON AGEING RESEARCH Canberra 24 September, 2003 “Linking research, policy and practice” Michael Marmot International Centre for Health and Society UCL

2 TRANSLATING RESEARCH EVIDENCE INTO POLICY SUCCESSES AND FAILURES

3 TRANSLATING RESEARCH EVIDENCE INTO POLICY SUCCESSES

4 0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 1.9 2 Admin Prof/Exec Clerical Other All Cause Mortality by Grade of Employment Whitehall Men 25 year Follow-up Marmot and Shipley, 1996 40-64yrs 64-69yrs 70-89yrs Relative rate

5 Independent Inquiry into Inequalities in Health REPORT CHAIRMAN: SIR DONALD ACHESON

6 GENERAL RECOMMENDATIONS u 1. Health Inequalities Impact Assessment All policies to favour the less well-off. u 2. High priority to women of childbearing age, expectant mothers and young children. u 3. Further steps to reduce income inequalities and improve living standards of poor households. Independent Inquiry into Inequalities in Health

7 AREAS FOR FUTURE POLICY DEVELOPMENT (1) u POVERTY & INCOME u HOUSING AND ENVIRONMENT u EDUCATION u MOBILITY, TRANSPORT, POLLUTION u EMPLOYMENT u NUTRITION u NATIONAL HEALTH SERVICE Independent Inquiry into Inequalities in Health

8 AREAS FOR FUTURE POLICY DEVELOPMENT (2) u MOTHERS AND FAMILIES u OLDER PEOPLE u ADULTS OF WORKING AGE u GENDER u ETHNICITY Independent Inquiry into Inequalities in Health

9 Tackling Health Inequalities Summary of the 2002 Cross-Cutting Review HM TREASURY

10 National Targets for Tackling Health Inequalities u 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” u 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.”

11 TRANSLATING RESEARCH EVIDENCE INTO POLICY FAILURES?

12 STRATEGIES FOR BUILDING RESEARCH CAPACITY

13 WHY DO WE NEED INTERDISCIPLINARY RESEARCH?

14 Social structure Social Environment Work Health Behaviours Patho-physiological changes Organ impairment Well-being Mortality Morbidity Genes Early Life Culture Brain Neuro- endocrine and immune Psychological Material factors

15 u EPIDEMIOLOGY u STATISTICS u SOCIOLOGY u SOCIAL PSYCHOLOGY u PSYCHOBIOLOGY u NEURENDOCRINOLOGY u ECONOMICS u MOLECULAR GENETICS

16 FUNDING INTERDISCIPLINARY RESEARCH

17 FUNDING INTERDISCIPLINARY RESEARCH?

18 RESEARCH INTO AGEING u Ageing as a lifelong process u Needs of older people

19 THE 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

20 RESEARCH INTO AGEING The English Longitudinal Study of Ageing (ELSA) General Background

21 Research team u International Centre for Health and Society, UCL u Institute for Fiscal Studies and UCL u National Centre for Social Research u plus researchers from Cambridge, Oxford, Nottingham Funding from NIA and UK government The English Longitudinal Study of Ageing (ELSA)

22 Key Research Areas u Health trajectories, disability and healthy life expectancy u The relationship between economic position and health u The determinants of economic position in older age u The timing of retirement, and post retirement labour market activity u The nature of social networks, support and participation u Household and family structure, and the transfer of resources

23 Broad questionnaire coverage u Demographics u Health u Social participation u Housing u Employment and earnings u Pensions and retirement

24 Broad questionnaire coverage (cont) u Income and assets u Cognitive function u Psychosocial u Expectations u Measurements u Self completion (social support, GHQ12, Beck depression inventory)

25 Collaboration with UK panel studies u 1946 birth cohort u Whitehall II –Testing of explanations for inequalities in health –Cohort growing older and retiring

26 Collaboration with UK panel studies u 1946 birth cohort u Whitehall II u BHPS –Full age cross-section –Focus on older people in 2002 wave –Sharing of topics and measures

27 Comparative issues u Ex-ante policy evaluation difficult u Understanding causal relationships difficult u 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 u Principal international comparators: Health and Retirement Study (HRS), SHARE

28 ELSA will look quite like HRS u Two-yearly frequency u Exit interview (post mortality, with proxy) u Modular structure + core content u Unfolding brackets u Financial respondent u Expectations u But with some differences: –biomedical health data –cognitive function –psychosocial factors –Face to face waves 1 and 2 (plus nurse visit wave 2)

29 FUTURE DIRECTIONS FOR AUSTRALIA?


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