The Burden of Disease and Inequalities in Health

Around 4% of babies are born with a congenital anomaly (CA). CAs are a major cause of infant mortality, childhood morbidity and long-term disability. EUROlinkCAT is a Horizon 2020-funded project which is supporting 22 congenital anomaly registries in 14 European countries to link their data on babies born with congenital anomalies from 1995-2014 to mortality, hospital discharge, prescription and educational databases. The use of a common data model and centrally-produced syntax scripts will allow us to investigate the health and educational outcomes of children with congenital anomalies for the first 10 years of their lives across Europe. This will expand the knowledge on the survival, health, disease determinants and clinical course of children according to their specific anomaly. Socio-economic health inequalities will also be investigated.

Through international collaborations including the earlier European Commission FP7-funded MedCHAMPS and RESCAP-MED projects, we have evaluated which policies are likely to be the most feasible and cost-effective in reducing the burden of diabetes and cardiovascular diseases in low- and middle-income countries. Research funded by the Qatari Foundation National Research Priorities Programme focuses on “forecasting the epidemiology and disease burden of diabetes”, as well as evaluating the most effective ways of preventing it.

The ethnically diverse communities of South London and elsewhere in the UK have been studied to document and explain differences in emerging risks of diabetes and cardiovascular disease in young people. Our research has highlighted how body mass index (BMI) can be a misleading marker of body fatness in children of ethnic minority origins. We have therefore developed a web calculator that provides adjusted BMI values to provide more accurate assessments of body fatness for children of South Asian and African origins.

As founder members of the International Study of Asthma and Allergies in Childhood (ISAAC), we have been involved for over 25 years in measuring the burden of respiratory disease nationally and globally.

In recent years, we have contributed to a compilation of global asthma statistics and an online compendium of UK statistics for lung disease. We have also highlighted the importance of healthy lungs as a predictor of longevity even in lifelong non-smokers.  

The implications of the worldwide epidemic of diabetes for the control of tuberculosis have been the subject of two recent and ongoing collaborations. The TANDEM collaboration investigated the best ways of screening and managing this comorbidity, as well as the biological basis for a link between diabetes and tuberculosis. A project funded by the Qatari Foundation NRPR project evaluated the potential global burden of these combined diseases and the effectiveness of interventions to reduce this burden.