Public health research ‘neglected’

2 April 2004

A national strategy is urgently needed to foster research into major public health problems in the UK, a study published in March 2004 has concluded.

The study, ‘Public Health Sciences: Challenges and opportunities’, was carried out by an independent Public Health Sciences Working Group chaired by Professor Stephen Frankel, Professor of Epidemiology and Public Health at the University of Bristol.

The Working Group was commissioned by the Wellcome Trust to consider the current state of the public health sciences – and how they relate to public health practice in the UK – and to recommend measures that would enhance their impact upon public health.

The report highlights the extraordinary gap between the importance of the public health sciences and the limited strategic interest that is taken in them.

Public health research has made enormous contributions to health improvement, from the sanitary reforms in the 19th century through to uncovering the dangers of smoking. The public health sciences also play a key role in guarding against new health hazards such as the threat of biological or chemical attacks, emerging infections such as SARS and BSE, environmental hazards, and diseases relating to lifestyle such as obesity, smoking and sexually transmitted infections.

In practice, public health sciences research is largely ignored until times of crisis. Even then, failure to record adequately the patterns of work carried out by multidisciplinary specialist teams can mean that experience is not carried through when similar circumstances arise in future.

Public health scientists are essential if the evidence base of public health interventionsis to be enhanced, but this area of research is seriously under-resourced, the report argues. In 2003, just 0.4 per cent of UK biomedical research publications were relevant to public health interventions.

Public health scientists are also deterred by ever-growing levels of bureaucracy. Permission to obtain data, patient information and biological samples is becoming ever more onerous.

The Working Group concluded that if public health sciences are to flourish, a concerted programme is needed to bring together three basic components: access to patient data that will reveal causes of disease and the impact of treatments and health improvement programmes; people competent to generate, manage and interpret such data; and a policy framework for implementing research outcomes.

To this end, the Working Group recommended that a high-level national academic public health strategy group should be established, effective but streamlined regulatory processes should be adopted, and long-term investment in the academic infrastructure should be a priority.

The Working Group advocated more collaboration between universities and the NHS, as well as the establishment of centres to bring together public health science, social science and public health service delivery. The Working Group also highlighted the need to foster a more informed dialogue between scientists, the public and the media to promote a better understanding of health risks.

A PDF of the report can be found at www.wellcome.ac.uk/phs.