Professor Cecily Kelleher has a vision for public health in Ireland. “Here in University College Dublin we have strategic opportunities to enhance public access to better health, by influencing policymakers through research. This generation has unprecedented access to good health, but there is a dark side; traditional patterns of inequality are changing and so too are patterns of ill-health. We cannot allow pockets of disadvantage, with all their associated health problems, to develop in urban sprawls and elsewhere. We need to avoid the problems that have visited other countries.”
Professor Kelleher has been involved in a number of health surveillance projects including the Obesity Task Force, the National Health and Lifestyles Surveys and, most recently, the Lifeways Cohort. The Lifeways Cohort is an extensive national project funded by the Health Research Board following the health outcomes of 1,124 mothers, their parents and their own children over five years. It is hoped that this wide ranging generational study will make valuable connections between the life courses and the health of individuals within their wider family context. The children are now at toddler stage.
As part of the work of the Lifeways Cohort programme, the unit established a three generation family study called the Lifeways Study in 2001 pictured are children involved in the study Saoirse Moore age 5, Susan Carroll age 5, Ciara Carroll age 7 and Leon Murphy age 5.
“Social variations across the life course influence health,” Professor Kelleher explains. “The Lifeways Cohort involves over 1,000 families, each comprising at least one mother, one child and one grandparent. About a third of fathers are also involved. Participants complete detailed questionnaires on health and social issues: where they live, their own attitudes to health, their lifestyles. We are also collecting information from GPs and hospitals pertaining to the mothers' obstetric histories, frequency of attendance of family members at the doctor and so on. We hope, in the course of this study, to gain some real insights into some of the common factors attending everyday illnesses.”
Professor Kelleher takes the example of childhood asthma, a growing condition that now affects at least one in six children in Ireland. “We hope to identify some patterns in maternal diet, heritability or environment that might take us closer to understanding this condition.” Patterns of health across the country are the subject of a number of studies currently underway at the UCD School of Public Health and Population Science. Geocoding of health services is an important tool for understanding how geography and access to healthcare interrelate. Everything from heart disease care to blood donation patterns is under scrutiny here, all with the objective of providing more effective interventions in a more democratic manner. When policymakers have detailed information about health patterns in Ireland they are better equipped to direct policy towards better health for all, Kelleher explains. They are also in a position to intervene with well-directed funding at points along the life cycle of citizens that may offset more costly and less effective interventions later. Professor Kelleher and her teams are keenly concerned with confronting misplaced and wasted expenditure in the health service.
Prof Cecily Kelleher, UCD School
of Public Health & Population
Science
Health economics is a central discipline of the School’s research in association with the UCD Geary Institute and the UCD School of Economics. “The ramifications of a project like Lifeways in terms of health economics are considerable,” she predicts. “Information linking life course factors and health service use can provide government with very valuable guidance when deciding how to get the best 'bang for the buck' in terms of investment. For example, early investment in the mother and infant may reduce the need for more expensive investment in heart disease care later.” It is useful, too, to understand how Ireland’s health patterns differ from other countries’. With an unusual two-tier health service and a protean population profile, it is important not to let negative health patterns ‘sneak up’ on unsuspecting services and to learn from the experiences of other jurisdictions. The UCD School of Public Health and Population Science has extensive links with academic institutions conducting similar research projects around the world. Professor Kelleher maintains a presence in both the public domain and in medical practice.