Epidemiology is the study of the distribution and determinants of diseases in populations. It is the key quantitative discipline that underpins public health, which is often defined as the organised efforts of society to prevent disease and to promote health. Most research and training in Cambridge in epidemiology and public health is encompassed by groups in the Institute of Public Health (IPH) at the Cambridge School of Clinical Medicine. The IPH was established as a tripartite collaboration in 1992 to promote multi-disciplinary research and teaching. The main constituents of the Institute include:
- The Department of Public Health and Primary Care of the University of Cambridge (head: Professor John Danesh)
- Three groups directly supported by the Medical Research Council (MRC): the MRC Biostatistics Unit (director: Professor Simon Thompson), the MRC Epidemiology Unit (director: Professor Nick Wareham) and the MRC Centre for Nutrition and Cancer Prevention and Survival (director: Professor Kay-Tee Khaw)
- Applied research groups of the National Health Service, including the Eastern Region Public Health Observatory (director: Dr David Pencheon).
- Public Health Genomics Foundation (director: Dr Ron Zimmern)
Investigators and groups in the University Department and other groups in the IPH (director: Professor Carol Brayne) are cross-linked by shared research programmes, joint appointments, and post-graduate teaching and supervision. There are strong collaborative links with several other departments at the Clinical School, research institutes in and around Cambridge (such as the Cambridge Institute of Metabolic Science and the Wellcome Trust Sanger Institute), and many other groups elsewhere in Cambridge, as well as nationally and internationally.
The overall objective of the work in the population health science, and in the University Department, is to provide scientific evidence that will help to promote health and prevent premature death and disability from major conditions. A key strategy is the integration of aetiological epidemiology with quantitative methodological research and clinical and laboratory sciences. Groups are also involved in the development and evaluation of preventive interventions focused on both individuals and populations. These have been given particular momentum in 2008 by the establishment of a Centre for Research Excellence in Public Health that is focused on diet and physical activity (director: Professor Wareham), and the establishment in 2010 of a Policy and Behaviour Research Unit (director: Professor Teresa Marteau).
The scope of the work in Cambridge encompasses studies of major non-communicable conditions, notably: common cancers, cardiovascular diseases, diabetes and obesity, and diseases of ageing, such as neurodegenerative conditions and bone disorders. An important cross-cutting approach is the analysis of data from large-scale population studies to help understand and identify the separate and combined influences of genetic and lifestyle factors in major diseases. Researchers in the University Department are at the forefront of generating population data on genes and biomarkers. This empirical work has been advanced by international leadership in the development of biostatistical and other methods to make optimum use of novel technologies such as genome wide association scans, as well as reliable characterisation of important lifestyle exposures, such as diet and physical activity.
Researchers in Cambridge have established several “in-house” epidemiological studies, typically involving detailed assessment of participants recruited from East Anglia and elsewhere in the UK, such as the 25,000-person EPIC-Norfolk Study and the 18,000-person MRC Cognitive Function and Ageing Study. They have also established and directed international collaborations to enable large-scale analyses of particular exposures or disease outcomes, such as the million-participant Emerging Risk Factors Collaboration of cardiac biomarkers, components of the 520,000-participant pan-European EPIC Study and the Breast Cancer Association Consortium involving genetic information on 40,000 women with breast cancer and 50,000 controls. Cambridge is increasingly involved in research in developing countries, exemplified by the Pakistan Risk of Myocardial Infarction Study, which is coordinated in collaboration with academic institutions in Pakistan and is already South Asia’s largest study of coronary disease.
Cambridge provides an outstanding training environment for biostatistics, epidemiology, public health and primary care, contributing substantially to national and international training. Its courses are internationally recognised, including MPhil courses in Epidemiology and in Public Health and a doctoral studies programme. A large proportion of students attending these courses have been supported by competitive national and international awards, including awards supported by the MRC, Gates, NIH-Cambridge, Cambridge Trust, CRUK, BHF, Department of Health, GlaxoSmithKline and overseas governments. Public health trainees also rotate through the University Department and are mentored by named senior investigators.
Prof J Danesh