Early life deprivation and adult cardiovascular risk in low- and middle-income countries.
Lead Research Organisation:
London School of Hygiene & Tropical Medicine
Department Name: Epidemiology and Population Health
Abstract
Material deprivation in early life is associated with increased cardiovascular disease in high-income countries, although the mechanisms explaining this are not well established. If true in low- and middle-income countries where material deprivation is highly prevalent, this could be an important contributor to cardiovascular disease in these settings. However data from low- and middle-income countries is lacking.
Establishing the association between early life deprivation and cardiovascular disease in low- and middle-income countries and its mechanisms is a priority for the development and appropriate targeting of public health interventions. For example determining the relative importance of biological pathways such as early life undernutrition compared to social pathways like formation of behavioural habits in childhood that continue into adulthood.
This PhD first aims to review existing literature on the association between early life deprivation and adult cardiovascular disease risk in low- and middle-income countries, and will then contribute to this limited evidence base by examining the association between early life deprivation and adult cardiovascular risk in a large sample of adults from two cohorts in rural and urban India. This will include investigating the relative role of adult behaviours (diet, activity, smoking) in explaining the association of early life deprivation with cardiovascular risk, and then examining specific hypothesised pathways (undernutrition, anaemia, vitamin deficiencies) in a prospective cohort of adolescents.
How this studentship meets MRC skills priorities
The main MRC skills priority area met by this studentship is quantitative skills, including statistics, data analytics, machine learning and more. Specially I have undertaken specialist training the following quantitative areas in order to be able to address the substantive research questions mentioned above:
- Data linkage and analysis of linked data (UCL 2018)
- Spatial data manipulation and analysis (LSHTM 2018)
- Multilevel modelling (Royal Statistical Society 2018)
- Machine learning (Royal Statistical Society 2019)
- Advanced methods to deal with missing data (University of Bristol 2019)
- Causal inference in epidemiology (University of Bristol 2019)
- New methods in mediation analysis (University of Bristol 2019)
- Mendelian randomisation (University of Bristol 2019)
Keywords
Epidemiology; cardiovascular disease; early life; lifecourse; material deprivation; undernutrition; social determinants; low- and middle-income countries; India.
Establishing the association between early life deprivation and cardiovascular disease in low- and middle-income countries and its mechanisms is a priority for the development and appropriate targeting of public health interventions. For example determining the relative importance of biological pathways such as early life undernutrition compared to social pathways like formation of behavioural habits in childhood that continue into adulthood.
This PhD first aims to review existing literature on the association between early life deprivation and adult cardiovascular disease risk in low- and middle-income countries, and will then contribute to this limited evidence base by examining the association between early life deprivation and adult cardiovascular risk in a large sample of adults from two cohorts in rural and urban India. This will include investigating the relative role of adult behaviours (diet, activity, smoking) in explaining the association of early life deprivation with cardiovascular risk, and then examining specific hypothesised pathways (undernutrition, anaemia, vitamin deficiencies) in a prospective cohort of adolescents.
How this studentship meets MRC skills priorities
The main MRC skills priority area met by this studentship is quantitative skills, including statistics, data analytics, machine learning and more. Specially I have undertaken specialist training the following quantitative areas in order to be able to address the substantive research questions mentioned above:
- Data linkage and analysis of linked data (UCL 2018)
- Spatial data manipulation and analysis (LSHTM 2018)
- Multilevel modelling (Royal Statistical Society 2018)
- Machine learning (Royal Statistical Society 2019)
- Advanced methods to deal with missing data (University of Bristol 2019)
- Causal inference in epidemiology (University of Bristol 2019)
- New methods in mediation analysis (University of Bristol 2019)
- Mendelian randomisation (University of Bristol 2019)
Keywords
Epidemiology; cardiovascular disease; early life; lifecourse; material deprivation; undernutrition; social determinants; low- and middle-income countries; India.
People |
ORCID iD |
| Sanjay Kinra (Primary Supervisor) | |
| Poppy Mallinson (Student) |
Studentship Projects
| Project Reference | Relationship | Related To | Start | End | Student Name |
|---|---|---|---|---|---|
| MR/N013638/1 | 01/10/2016 | 30/09/2025 | |||
| 1803826 | Studentship | MR/N013638/1 | 01/10/2016 | 30/09/2020 | Poppy Mallinson |
| Description | LSHTM Public Engagement Small Grants Scheme (£1000), MRC LID Flexible Funding Scheme (£800) |
| Amount | £1,800 (GBP) |
| Organisation | London School of Hygiene and Tropical Medicine (LSHTM) |
| Sector | Academic/University |
| Country | United Kingdom |
| Start | 07/2018 |
| End | 03/2020 |
| Description | Placement with Government of Telangana, India |
| Organisation | Government of Telangana |
| Country | India |
| Sector | Public |
| PI Contribution | Undertook a three month placement in the Life Sciences division of the industrial promotion wing of the Telangana State government. My role was to assist on ongoing projects related to the digital health ecosystem in Telangana and strengthen link between my research group in LSHTM and Government of Telangana. |
| Collaborator Contribution | Mentorship and guidance, provided opportunities to present ideas and findings. |
| Impact | I gained training and experience in engagement with policy makers and policy making processes. Contributed to development of a digital health strategy for Telangana State. Contributed to proposals for longer term collaborations between Government of Telangana and London School of Hygiene and Tropical Medicine. |
| Start Year | 2019 |
| Description | Series of workshops in secondary schools to learn about careers in public health |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | Local |
| Primary Audience | Schools |
| Results and Impact | I led a group of MRC PhD students in getting funding for, developing and delivering a public engagement activity with local schools. We visited 3 schools in the London area to deliver a total of 6 2-hour workshops on careers in public health. A class of between 20 and 40 students in year 10/11 were asked to help answer questions to advise the government on how to stop a simulated malaria outbreak that had just begun in London. Students were asked at the beginning of the session for what careers they thought would be involved in this work. They then got to see how people at LSHTM would be involved - epidemiologist, entomologists, statisticians, modellers and diagnosticians - to demonstrate the range of science careers available in public health. Each career had a stand where students learned about the work of that profession in 15 minutes with interactive learning tools used. School students asked lots of questions about epidemiology/public health and career paths involved, and we received excellent written feedback from the teachers present. All 3 schools have invited us to come back and deliver the workshop to further classes. |
| Year(s) Of Engagement Activity | 2018,2019,2020 |