To what extent does your situation in life influence your health? 

It’s a question that drives the work of Professors Frank Kee and Amy Jayne (AJ) McKnight at Queen’s University Belfast. They want to know more about the ‘social determinants of health’ – the technical term for all the non-medical things that impact your health throughout your life. Things like where you live, what you do at work, how much money you earn, and how you spend your free time.  

We already know that these factors are linked to our health. For example, we know that people with lower incomes are more likely to have long-term health conditions. But we don’t always know the precise role they play. Are conditions caused by our environment, or our genetics, or a combination of the two? And if the answer is a combination, is there a factor that plays a dominant role? 

Frank and AJ want to get beneath the surface of these questions. By learning more about health inequalities across the UK, they hope to improve the way healthcare is provided, so more people can live longer and healthier lives. 

And they believe Our Future Health can help them to get there. 

Spotting inequalities across the nation

“A programme that has health information from up to 5 million people allows you to ask questions that aren’t possible with fewer people,” says Frank, Professor of Public Health Medicine in the School of Medicine, Dentistry and Biomedical Sciences at Queen’s.  

“The large size of Our Future Health’s volunteer group means we can drill down into different health inequalities and try to understand them better. 

“The data will give us an insight into how our genetics, environment and life experience influence our risk of disease over the course of our lives,” says AJ, Professor of Molecular Epidemiology and Public Health.  

“We should be able to see the inequalities that exist in access to treatment, too. With that knowledge, we can advocate for better healthcare policy that serves everyone.”  

Frank picks up the baton. “One of the things that sets Our Future Health apart is that it’s UK-wide. The programme is already live in England, Scotland and Wales, and groundwork is being laid for it to launch in Northern Ireland. 

“Healthcare policies vary across the four nations. It’s like a natural experiment that allows us to look at the impact of different policies on health outcomes. There’s great scope to learn about the social determinants of health – and how we can reduce peoples’ risk of diseases.  

“With Our Future Health, we can interrogate the big questions in healthcare with impressive granularity.”  

Improving treatment for diabetes and kidney disease

Frank and AJ’s plan is to begin with a study that investigates health inequalities in treatment for diabetes and kidney disease.  

“We’re working with Diabetes UK and Kidney Research UK, both affiliate charity partners of Our Future Health, to advocate for everyone to have equitable access to treatment,” says AJ. “Both diabetes and kidney disease are public health priorities due to rapidly rising numbers.”  

Diabetes UK estimates that there are now 4.6 million people in the UK who have a diagnosis of diabetes – an all-time high. This figure is up from 4.4 million people last year.  

An estimated 6.3 million people live with prediabetes, but some are not yet aware of this. If left untreated, prediabetes can develop into type 2 diabetes. A further 1.3 million are living with undiagnosed type 2 diabetes.  

AJ says that roughly half of those people may develop kidney disease in their lifetimes, which is a leading cause of kidney failure. 

“One thing that interests us is that some people living with diabetes are more likely to develop kidney disease than others. For example, people from lower-income groups, and people from Black or Asian backgrounds, are more likely to develop chronic kidney disease, are more likely to progress faster towards kidney failure, and are more likely to die because of kidney disease,” AJ explains. 

“We know that more intensive surveillance and treatment can help delay the progression of kidney disease. But people from these groups often face barriers to accessing timely or appropriate healthcare. People from non-White backgrounds are also less likely to receive a transplant than people who self-report as White ethnicity.” 

The need for quality data

“We must argue for policy changes to minimise these inequalities – and to do that, we need high quality data,” says AJ. “In the past, researchers like me have had to rely on data that has significant gaps. For example, we’ve had data that doesn’t show the ethnicity of the patient, or the income level.”  

“We don’t currently understand exactly why individuals who live in areas of higher socioeconomic deprivation are more susceptible to diseases like kidney disease and diabetes,” says Frank.  

“But Our Future Health’s rich data will help us to unpick associations and identify real, modifiable causes to reduce disease burden.” 

Learn more about diabetes and kidney disease

Diabetes UK offers information about type 1 and 2 diabetes, as well as support for patients and carers.  

Kidney Research UK helps shape the treatment and care of people living with kidney disease.  

Diabetes UK and Kidney Research UK are affiliate charity partners of Our Future Health.