Department of Public Health and Primary Care (DPHPC)
The Department of Public Health and Primary Care includes several major research groups, such as the Cardiovascular Epidemiology Unit, the Cancer Genetic Epidemiology Unit, the Primary Care Research Unit, the Behaviour and Health Research Unit, and the Cambridge Centre for Health Services Research (some of which are described in separate sections below).
The Department’s overarching goal is to generate evidence that will inform the prevention of premature death and disability, the promotion of health, and the formulation of evidence based health policy.
Read more about Department news at: www.phpc.cam.ac.uk
- The interface between epidemiology and clinical medicine – highlights
- Population scale “multi-omics”
- Big data for population health
- Dementia prevalence
- Global health initiatives
- New research fellowships
- New strategic partnerships
The interface between epidemiology and clinical medicine – highlights
Analysis of the 2.5 million-person Emerging Risk Factors Collaboration has informed international cardiovascular guidelines by showing that there is little incremental prediction provided by assessment of C-reactive protein (NEJM 2012), lipoproteins (JAMA 2012), glycated haemoglobin (JAMA 2014), or fatty acids (Ann Int Med 2014). Investigators in the Cardiovascular Epidemiology Unit have also helped confirm that inhibitors of the NPC1L1 protein, such as ezetimibe, are expected to lower cardiovascular risk (NEJM 2014), and identified triglyceride-rich pathways (Nature 2015) and pathways relating to both height and coronary disease as potential therapeutic targets (NEJM 2015).
In a major collaboration between the University of Cambridge and the Wellcome Trust Sanger Institute, cohort-wide whole genome sequencing (at a high depth) has commenced for the 50,000 blood donors in the INTERVAL study (PI: Professor Danesh). The objective is to
lay foundations for new approaches to disease prevention by gaining novel insights into the genomic regulation of several thousand molecular phenotypes (eg, lipids, metabolites), linking this information with a variety of chronic disease outcomes. This work is being widened to proteomics in a major collaboration with Merck (co-PI: Dr Adam Butterworth). To enhance connectivity between epidemiology and biology, the Department appointed Dr Dirk Paul as Lecturer in Integrative Human Genomics in 2015.
Big data for population health
In an analysis led by Dr Emanuele Di Angelantonio, Professor Simon Thompson and others in the Department involving 1.2 million participants in population cohorts that have recorded 135,000 deaths, it was shown that mortality associated with a history of diabetes, stroke, or myocardial infarction was similar for each condition (ERFC, JAMA, 2015). Because any combination of these conditions was associated with multiplicative mortality risk, life expectancy was about 15-20 years lower in people with cardiometabolic multimorbidity. To enhance leadership in data science, the Department established a Readership in Translational Genomics and Data Science in 2015 (currently under recruitment).
Number of people with dementia in some Western European countries could be stabilising
Risk of dementia may be falling due to improved education and living conditions, and better prevention and treatment of vascular diseases,
highlighting the need for policies to improve health across the lifecourse (Wu, Y et al, Lancet, 2015).
The suggested decrease in dementia occurrence coincides with improvements in protective factors such as education and living conditions and a general reduction in risk factors such as vascular diseases over recent decades. Policies which address determinants of health in earlier life stages and enhance cognitive reserve for populations may have the greatest long term impact on reduction of dementia risk at given ages in later life as well as on population health more generally.
– Professor Carol Brayne
Global Health Initiatives
Dr Rajiv Chowdhury, Dr Di Angelantonio and others have expanded efforts in Bangladesh to study the relevance of arsenic exposure and other toxic metals to cardiovascular disease by enlarging the “BRAVE” case-control study of myocardial infarction to almost 15,000 participants. To study the determinants and consequences of anaemia across different age groups in Bangladesh, the same investigators have commenced a pilot study which aims to enrol 20,000 further participants through a household survey. Investigators in the Department are co-investigators in the new Multi-Ethnic New Zealand study of Acute Coronary Syndromes (MENZACS), which aims to identify the biological and other determinants of cardiometabolic conditions in people of Maori, Pacific Island, and other ethnicities at high-risk of such conditions.
New research fellowships
In 2015 Homerton College, the largest college of the University, and the Department of Public Health and Primary Care jointly established four-year Junior Research Fellowships in the areas of cancer genomics and global health.
New strategic partnerships
In October 2015, the £4 million NIHR Blood and Transplant Research Unit in Donor Health and Genomics (Director: Professor Danesh) was launched. This initiative, which involves NHS Blood and Transplant and the Sanger Institute as strategic partners, aims to enhance the safety
and efficiency of blood donation through basic and applied population health research. In another multi-department collaboration spanning
population health, vascular biology, and functional genomics, the £3 million British Heart Foundation Cambridge Centre of Cardiovascular Excellence (Director: Professor Nick Morrell) was launched last year. As an extension of this interdisciplinary strategy, the University plans to create a major Heart and Lung Research Institute (to include cardiovascular epidemiology) immediately adjacent to the re-located Papworth Hospital, the UK’s largest cardiothoracic centre.
The Department has also been closely involved in Cambridge’s engagement with the national Alan Turing Institute in Data Science. The Turing Institute was established in 2015 in partnership with the University of Cambridge (and four other universities in the UK) with the aim of harnessing computational and mathematical sciences to advance discovery and applied sciences (including population health and medicine), using largescale and diverse digital data.