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NATIONAL SYMPOSIUM ON AGEING RESEARCH Canberra 24 September, 2003 “Linking research, policy and practice” Michael Marmot International Centre for Health and Society UCL. TRANSLATING RESEARCH EVIDENCE INTO POLICY. SUCCESSES AND FAILURES. TRANSLATING RESEARCH EVIDENCE INTO POLICY. SUCCESSES.

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Translating research evidence into policy

NATIONAL SYMPOSIUM ON AGEING RESEARCHCanberra24 September, 2003 “Linking research, policy and practice” Michael MarmotInternational Centre for Health and SocietyUCL


Translating research evidence into policy

TRANSLATING RESEARCH EVIDENCE INTO POLICY

SUCCESSES AND FAILURES


Translating research evidence into policy1

TRANSLATING RESEARCH EVIDENCE INTO POLICY

SUCCESSES


Translating research evidence into policy

All Cause Mortality by Grade of Employment

Whitehall Men 25 year Follow-up

Admin

2

Prof/Exec

1.9

Clerical

1.8

Other

1.7

1.6

1.5

1.4

1.3

1.2

1.1

1

0.9

0.8

0.7

0.6

0.5

0.4

0.3

0.2

0.1

0

Relative rate

40-64yrs 64-69yrs 70-89yrs

Marmot and Shipley, 1996


Translating research evidence into policy

Independent Inquiry into

Inequalities in Health

REPORT

CHAIRMAN: SIR DONALD ACHESON


General recommendations

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


Areas for future policy development 1

AREAS 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


Areas for future policy development 2

AREAS FOR FUTURE POLICY DEVELOPMENT (2)

  • MOTHERS AND FAMILIES

  • OLDER PEOPLE

  • ADULTS OF WORKING AGE

  • GENDER

  • ETHNICITY

Independent Inquiry into Inequalities in Health


Translating research evidence into policy

Tackling Health Inequalities

Summary of the 2002

Cross-Cutting Review

HM TREASURY


National targets for tackling health inequalities

National 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.”


Translating research evidence into policy2

TRANSLATING RESEARCH EVIDENCE INTO POLICY

FAILURES?


Strategies for building research capacity

STRATEGIES FOR BUILDING RESEARCH CAPACITY


Why do we need interdisciplinary research

WHY DO WE NEED INTERDISCIPLINARY RESEARCH?


Translating research evidence into policy

Material 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


Translating research evidence into policy

  • EPIDEMIOLOGY

  • STATISTICS

  • SOCIOLOGY

  • SOCIAL PSYCHOLOGY

  • PSYCHOBIOLOGY

  • NEURENDOCRINOLOGY

  • ECONOMICS

  • MOLECULAR GENETICS


Funding interdisciplinary research

FUNDING INTERDISCIPLINARY RESEARCH


Funding interdisciplinary research1

FUNDING INTERDISCIPLINARY RESEARCH?


Research into ageing

RESEARCH INTO AGEING

  • Ageing as a lifelong process

  • Needs of older people


Translating research evidence into policy

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


Research into ageing the english longitudinal study of ageing elsa

RESEARCH INTO AGEINGThe English Longitudinal Study of Ageing(ELSA)

General Background


The 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

The English Longitudinal Study of Ageing (ELSA)


Key research areas

Key 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


Broad questionnaire coverage

Broad questionnaire coverage

  • Demographics

  • Health

  • Social participation

  • Housing

  • Employment and earnings

  • Pensions and retirement


Broad questionnaire coverage cont

Broad questionnaire coverage (cont)

  • Income and assets

  • Cognitive function

  • Psychosocial

  • Expectations

  • Measurements

  • Self completion (social support, GHQ12, Beck depression inventory)


Collaboration with uk panel studies

Collaboration with UK panel studies

  • 1946 birth cohort

  • Whitehall II

    • Testing of explanations for inequalities in health

    • Cohort growing older and retiring


Collaboration with uk panel studies1

Collaboration 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


Comparative issues

Comparative 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


Elsa will look quite like hrs

ELSA 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)


Future directions for australia

FUTURE DIRECTIONS FOR AUSTRALIA?


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