Using 'Big Data' in Public Health.

The Sandy Macara Memorial Lecture
Dr Tom Cromarty, Paediatric Trainee​

Last week I attended the Sandy Macara Memorial Lecture which was hosted by the BMA at the Millenium Centre. Alexander (Sandy) Macara was an internationally renowned public health physician and chairman of the BMA council, being one of the key figures campaigning against the tobacco industry. @FrankAtherton opened the evening highlighting the fantastic work which Wales has done in relation to Public Health. This included Wales being the first country to bring in presumed consent for organ donation, world leading legislation such as the ‘Well-being of Future Generations Act’ (2015), continued work on the ACEs (Adverse Childhood Experiences) and recently new regulations for tattooists in Wales. He also highlighted the need to reflect on the history of public health to be successful in steering the future of public health, with big data playing a role in this.

​Professor Ronan Lyons (Professor of Public Health at Swansea University) then highlighted some of the amazing Public Health work that he has been involved with, focussing on the SAIL Databank (over the past 10 years) and current developments such as Health Data Research UK (@HDR_UK).
 
The Secure Anonymised Information Linkage Databank started in 2009 and is continuing to collect data which is then 'de-identified' so that it can be analysed by researchers across the world. This data from patients in Wales combines health and population data for >5 million people, so far creating 26+ billion rows of data.

SAIL Datasets

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​Privacy is absolutely paramount, meaning that this is the only dataset that is globally accessible as long as researchers meet the criteria of being safe and accredited. Every project proposed must also meet some strict inclusion criteria, such as ensuring that the research’s purpose is to protect people and it is in the public interest, etc.
 
This resource of ‘big data’ has already enabled a number of research projects which have guided policies and public health advice to families across Wales. Many of these projects have involved Paediatrics:

• Gestational Age, Birth Weight, and Risk of Respiratory Hospital Admission in Childhood. DOI: https://doi.org/10.1542/peds.2013-1737. Showing differences in hospital admission rates between babies born at 39 and 40 weeks’ gestation at a population level.

 

• Change in alcohol outlet density and alcohol-related harm to population health (CHALICE): a comprehensive record-linked database study in Wales. Showing the link between alcohol-related harm and outlet density. Therefore helping to guide policies and the regulation of alcohol outlets in a given population.

 

• Population data also showed the positive effect of the Welsh ‘Warm homes NEST scheme’. This provided evidence of its impact on the health of the population and helped secure continued funding at a time when austerity saw many other public schemes discontinued. 

HealthData Research UK (@HDR_UK) is aiming to do the same as SAIL in Wales but across the whole UK with a larger data set.
 
Ronan made it clear that we are coming to a tipping point with the vast amounts of health data that is being collected. This gives huge potential for positive impacts if used safely and correctly. There are exciting innovations such as the ‘Personalised Genome’ enabling personalised medical interventions, whilst wearables (and other technology) can encourage the self-monitoring of health and disease. The challenge is to reduce inequalities in health without reducing gross disparities in wealth.
 
The public are rightly concerned about the security of their data, especially with the data security scandals of various social platforms in recent years. Public trust needs to be built and earned. SAIL has a consumer panel, composed of members of the public. These individuals are involved with the accreditation of certain projects and often help them throughout the research process.

Future Paradigm of the Learning Healthcare system

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The whole lecture will be available to view on the BMA website in due course.

Check it out!
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​If there are any questions then please get in touch.