ARI 1: early action to prevent poor health outcomes

Research objective: Research to understand and deliver prevention, timely diagnosis and appropriate intervention for people at increased risk of poor health (in particular obesity, cardiovascular disease, type 2 diabetes, mental health and cancer) to prevent excess deaths, improve population health (including the health of the working age population), reduce disparities and reduce reliance on health and social care.

Priority research topics: Developing, evaluating and understanding how to implement interventions which prevent health problems developing, accurately identify those at risk, effectively manage risk factors and treat conditions early, and manage health problems to prevent severe disease in the 4 areas set out below.

- Prevent: Interventions to prevent health problems, developing effective routes to reach those who are most at risk or marginalised, and understanding how to effectively implement proven interventions at scale (for example, antihypertensives, mental health programmes for children and young people, vaccines for cancer or workplace preventative interventions).

- Identify: New ways of identifying those most at risk (for example, predictive analysis of GP records to identify those who would benefit from early intervention, new methods of cancer screening and new approaches to diagnosing the causes of chest pains).

- Treat: Interventions early in the course of disease progression (for example, social prescribing, early intervention for cancer or interventions to enable people to remain in or return to work).

- Manage: Interventions to improve the management of multiple long-term conditions (for example, how to manage side effects in polypharmacy), prevent acute events (such as heart attacks, strokes and mental health crises) and ensure effective rehabilitation after these events to reduce long-term illness and disability.

Background

Suboptimal management of risk factors for common diseases (including hypertension, poor metabolic control, late detection of cancers and poor mental health):

- drives morbidity and mortality
- reduces the proportion of the population able to work and impacts healthcare delivery within the NHS and social care systems

Cardiovascular diseases, type 2 diabetes and many cancers are increasing in prevalence in the UK. For example, there were 5.8% more cancer diagnoses in 2019 compared to 2017 and diagnosed diabetes has increased from 2% of the population in 1994 to 7% in 2019, including sharp increases in those aged under 40 years. Mental health problems spiked during the pandemic, and in children and young people remain above pre-pandemic levels. Among 17 to 19 year olds, the proportion with a probable mental disorder increased from 17.4% in 2021 to 25.7% in 2022.

The costs to the individual, the health and care system and the economy is large. In 2022, around 2.5 million people in the UK were economically inactive due to ill health, an increase of 688,000 since 2019. Cardiovascular disease costs the UK economy £15.8 billion a year and the NHS £7.4 billion, while the NHS spent over £10 billion on diabetes care in 2019, with one in 6 hospital beds occupied by someone with diabetes.

Research is needed into how best to prevent disease, ensure timely diagnosis and develop appropriate interventions to prevent acute events and chronic disease. This could significantly improve health and economic outcomes for individuals, support a healthy workforce and reduce pressure on the NHS and social care. For example, preventative interventions and early diagnosis are estimated to reduce strokes, heart attacks and dementia cases by 150,000 over 10 years, saving £2.3 for every £1 spent. In England, more than 90% of people survive bowel, breast and ovarian cancer for at least 5 years if diagnosed at the earliest stage, and Cancer Research UK estimates the cost of treating late-stage colon, rectal, lung and ovarian cancer is nearly two and a half times the amount for early-stage treatment (PDF, 1.35MB). In England, early interventions for mental health problems can reduce hospital admissions, shorten hospital stays and require fewer high-cost intensive interventions potentially saving up to £38 million per year.

Next steps

See https://www.gov.uk/government/publications/department-of-health-areas-of-research-interest/ for more information.

Source

This question was published as part of the set of ARIs in this document:

DHS Cs areas of research interest GOV UK

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