Geography Reference
In-Depth Information
burden on health systems as well as pension funds. It is now recognized
that many people have a healthy old age, requiring constant care only
in the final months of life, but this has led to a new emphasis on re-
search into the factors deciding who will experience healthy old age and
how the proportion of such people can be increased. This has become
linked to medical research that has demonstrated a strong relationship
between what happens to people before they are born and in infancy and
their health much later in life. This research began with a classic study
by David Barker into the relationship between a baby's nourishment,
as recorded by weight at birth and subsequently, and the risk of death
from coronary heart disease.
2
More recent research into the “Barker hy-
pothesis” has explored the wider impact of deprivation in infancy.
3
Such
research forms the background to major government programs such as
Head Start in the United States and Australia and Sure Start in the UK.
4
Given that such research is an urgent public priority, starting to
gather data on babies now and reporting the results in sixty to eighty
years will not do. The research has to be based on recent data on health
in old age for individuals whose experience as babies has already been
recorded: it has to be based on historical data. Three different approaches
have been taken in UK research.
First, George Davey Smith and his collaborators located data on
4,999 babies studied by Sir John Boyd-Orr in 1937-39, which included,
as well as measurements of height and weight, names and addresses.
The same individuals were then in 1988 located in the modern National
Health Service Central Register and asked if they were willing to take
part in a follow-up study.
5
Note that all the research described in this
section is substantially limited by rules governing access to confidential
data on living people and their health, although space also does not allow
a detailed account.
Second, David Strachan used data from the Office of National Sta-
tistics Longitudinal Study (LS), which links together data for 1 percent
of the population of England and Wales from the 1971, 1981, 1991, and
2001 censuses plus information on events such as births, deaths, and
cancer registrations; it covers just over half a million people at each cen-
sus.
6
That clearly tells us nothing about conditions in childhood, but
Strachan discovered that the members of the LS were identified by their
