Epidemiology and health intelligence
Better, more sustainable, and locally responsive population health intelligence systems are needed to monitor non-communicable diseases (NCDs), their impacts on population health, and the response of health and care systems.
Research in this theme critically investigates the sharing and collaborative use (and limits) of national and local electronic healthcare record/registry (EHR) data and their linkages as sources of data and intelligence for population health management. This includes conducting large-scale population surveys and, with participant consent, linking patient-reported measures to EHR data to estimate the distribution of NCDs, and associated disability, health-related quality of life, and employment outcomes, as well as patterns of healthcare utilization. A feature of many ‘forgotten’ NCDs is the relative absence of population health metrics and tools to support evaluation and predictive prevention. We work with academic and non-academic partners to develop, evaluate, and implement new measures and tools to address these gaps.
Population health indicators and tools
Estimating Healthy Working Life Expectancy in England
Healthy working life expectancy (HWLE) is a population indicator that takes account of both health and work states and provides an indication of whether extensions to working life are achievable. This work is increasingly valued by the Department for Work and Pensions (DWP) who are interested in:
- the estimates of HWLE to inform pension policy,
- the identification of factors and mechanisms that are amenable to change and could be targeted by health and social policy to increase the number of years people remain healthy and in work. The range of potentially modifiable health and social targets will require a number of approaches; a social approach to reduce the impact of social, psychological and lifestyle factors, and a policy approach to address inequities to care and interventions in the workplace.
The HWLE team are developing methods for calculating HWLE on a continuous basis as a measure of long term trends in workability of older adults. The team collaborate with the Joint Work and Health Unit within DWP and the Fuller Working Lives/State Pension Age group who are interested in the results linked to the role of the employer and workplace adjustment on HWLE.
Links: Centre for Musculoskeletal Health & Work, HLWE
People: Marty Parker, Ross Wilkie, Milissa Bucknall
Key references:
- Population-based estimates of healthy working life expectancy in England at age 50 years: analysis of data from the English Longitudinal Study of Ageing. Lancet Public Health. 2020.
- Extending Working Lives: A Systematic Review of Healthy Working Life Expectancy at Age 50. Soc Ind Res. 2020
Defining non-communicable diseases and quality of care in the electronic health record
Electronic health records, created in the process of providing care, are a potentially powerful source of information for monitoring health and care in populations. Research on how to define non-communicable diseases, care processes, determinants, and outcomes within the electronic health record underpins their valid and meaningful re-use for population health management.
| Links: MRR People: Kelvin Jordan, Dahai Yu, John Edwards, Krysia Dziedzic Key references:
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Musculoskeletal Health Questionnaire (MSK-HQ)
Musculoskeletal outcome tools are fragmented across different settings and conditions. Working with colleagues in the University of Oxford and with Versus Arthritis, this research aimed to provide patients and practitioners across the musculoskeletal pathway with a practical tool for quantifying and monitoring the impact of musculoskeletal symptoms.
- Development of the new measure and evaluation of its measurement properties
- Exploring how managerial and commissioning decisions are influenced by the availability of MSK-HQ outcome data
- Implementation in local musculoskeletal services
Links: MSK-HQ, MSK-Tracker
People: Dr Jonathan Hill
Key references:
- Development and initial cohort validation of the Arthritis Research UK Musculoskeletal Health Questionnaire (MSK-HQ) for use across musculoskeletal care pathways. BMJ Open. 2016.
- Determining responsiveness and meaningful changes for the Musculoskeletal Health Questionnaire (MSK-HQ) for use across musculoskeletal care pathways. BMJ Open. 2019.
