Our main remit in the Prevention Centre is to facilitate the identification, synthesis and implementation of what we know works from research in prevention of chronic disease.
We have largely stayed away from discovery research – that is, finding new ways to better prevent chronic disease – though in prevention research there is a spectrum between discovery and translation.
However, in our work program for this second period of funding, we included a small project to look at future of prevention of chronic disease, which we grandly titled NextGen Prevention.
It is important that prevention science does not stand still – we are part of a broader research community where new ideas are emerging that may have relevance for better prevention.
A recent article in the BMJ provided a great example of how new research approaches can give us new insights into risks that we thought we understood. This study used a variation on a technique called mendelian randomisation to quantify education inequalities in health. It showed that while the well-recognised risk factors of BMI, systolic blood pressure and smoking behaviour mediated a substantial proportion of the protective effect of education on the risk of cardiovascular disease, more than half of the protective effect of education remained unexplained.
One of the challenges in our project is that prevention draws on a very broad range of disciplines – social and behavioural sciences as much as biological and physical sciences. New directions will emerge from fields like genomics, microbiomics, environmental and climate science and engineering, but in prevention of chronic disease these will usually need to be interpreted with knowledge of the social and economic context of the relevant population and of human behavioural response in relation to such change.
Moreover, with our living environment increasingly challenged by climate change, it is not only desirable but necessary to think about the broader implications of changes we might promote for individual human health. The impacts of excessive calorie intake from highly processed foods is not just about obesity but about sustainability of our food system.
The Prevention Centre was established to promote the systems perspectives on the prevention of lifestyle related chronic conditions. We think that systems perspectives help better understand the complex interactions of these microsystems, and should include the linkage to broader system issues.
So, our exploration of the future of prevention of chronic disease will be as challenging as preventing chronic disease itself!