The environments in which we live are already determining our health in 2040. Health is shaped by a confluence of myriad factors, including the air we breathe, the food we eat, the work we do, the taxes we pay, the places we live, and the people we know.”
So begins a new report exploring how UK’s research environment should adapt to meet the complex health challenges the population will face by 2040. Released by the Academy of Medical Sciences, it is likely to be of interest and use to many Croakey readers.
By 2040, we can expect that our planet will be warmer, our air more polluted and our natural resources more depleted than ever, it says.
It suggests the need for reconfiguration of research so that it is far more transdisciplinary, and involves disciplines that would not usually be considered within the public health field. In a similar vein, it suggests re-thinking the field of “public health” as the “health of the public”.
Many future health challenges will be global in nature – such as climate change, conflicts, resource depletion, the rise of mega-cities, emerging infectious diseases, widespread antimicrobial resistant pathogens, food and water security, non-communicable diseases, and inequalities in access to health and social care. These will require international responses and a commitment to global partnerships.
The report, ‘Improving the health of the public by 2040: Optimising the research environment for a healthier, fairer future’, suggests that the greatest health gains will come from preventive interventions across the population, and that such interventions can reach those at highest disease risk who may also be the most difficult to reach with other effective interventions.
It cautions that greater adoption of high-cost individual interventions may not only put pressure on the sustainability of the health and social care system, but widen health inequalities as access and uptake are less likely among the socioeconomically disadvantaged.
While emerging data, knowledge and technologies offer new opportunities to tackle some of the challenges ahead, they may also introduce new harms and will require global coordination if they are to provide solutions to global problems.
To help achieve the report’s vision of a healthier, fairer future, it says a paradigm shift is needed in several key areas:
- Environments: All elements of the UK environment must support healthy living for everybody based on a robust understanding of how to create a health-promoting society and conditions conducive to improving health equity.
- Empowerment: People – particularly those who are most vulnerable to poor health outcomes – must be empowered to actively contribute to their own and other people’s health through meaningful and iterative engagement; effective communication of health information; and shared decision-making over their care.
- Values: All sectors of society – including all policymakers, health and social care practitioners and commercial bodies – should value health and health equity and these should be treated as indicators of success.
- Sustainability: Improvements to health must be gained in ways that are economically, environmentally and socially sustainable through greater focus on preventive intervention at the population level. The relationship between planetary and population health should be explicitly recognised.
- Resilience: The UK must develop resilience to potential health crises – with all levels of Government having high levels of preparedness and adaptability – and be a major contributor to global health security.
While public health research has traditionally been collaborative, the report says a number of barriers will need to be overcome to facilitate joint working in “health of the public” research:
A recurring theme in this project has been the need to move beyond professional silos and address health needs holistically. For instance, certain disciplines – such as social care and environmental and occupational health – are underrepresented in health of the public research.
Experts from some disciplines such as informatics are sometimes being seen as a service provider and not as a co-creator of research outputs. There are silos between medically-trained public health practitioners, the rest of the medical community and those coming from disciplines outside of medicine.
It is important to build research around ‘question-focused’ groupings with shared goals rather than the traditional disciplinary-based groupings. Greater flexibility for individuals to move between disciplines related to health of the public is also required.”
The report recommends that higher education institutions:
- Incorporate opportunities for learning about health in a wide range of disciplines relevant to the health of the public.
- Incorporate these broader disciplines into public and population health courses.
- Consider mechanisms for building joint modules between public and population health and these other disciplines to foster transdisciplinary approaches to learning and research.
While much of the report will be of relevance and interest in the Australian context, some of its recommendations present a huge challenge to our current ways. For example:
We recommend that each Government department reviews how it obtains evidence and advice on health and health equity, in order to ensure that impact on health and health equity is incorporated in the development of all relevant policies within departments and across Government.”
Just imagine that in the current Australian context!!
The report’s authors state:
“We challenge all those working in fields that affect human health to come together with the public in pursuit of our aspiration for a future in which the UK experiences substantial, sustainable and ongoing improvements in health and health equity.”
Just imagine that in the current Australian context!!
Perhaps Croakey readers with time on their hands might like to do some further analysis? Perhaps contrast and compare the report’s framing and recommendations with this recent slideshow from Australia’s Medical Research Future Fund.