The Department (www.epi.bris.ac.uk) is a leading centre for epidemiology, health services research and public health in the UK and was one of only three to be awarded the top 5* grade in the 2001 Research Assessment Exercise. The skills of a variety of health care researchers including statisticians, epidemiologists, sociologists, psychologists, anthropologists, health economists, public health physicians and nurses, are all available and contribute to the excellent working environment in which to undertake interdisciplinary research and teaching. The Department is the home for the main centre of the Medical Research Councils Health Services Research Collaboration. The department has extensive collaborations with many clinical and other departments in the University of Bristol, throughout the UK and internationally.
The department has two major research divisions - aetiological epidemiology and health services research.
Aetiological Epidemiology
The Epidemiology Divisions principal research programme is concerned with lifecourse epidemiology - the ways in which exposures at different stages of the lifecourse interact to produce patterns of chronic disease. Until recently, studies of this sort have been almost exclusively concerned with the effect of factors acting in adult life but attention has recently turned to the long term influences of factors operating in the intra-uterine and early post-natal period. Chronic disease epidemiology is now being extended to examine the way in which exposures, including biological and genetic factors, accumulate and interact throughout life. The departments programme of research is based upon the study of a series of major cohorts, many with stored genetic material, and several more are currently being constructed. We have close collaborative links with Avon Longitudinal Study of Parents and Children (ALSPAC). Members of academic staff have additional interests in the epidemiology of ageing (Prof. Shah Ebrahim), neurodegenerative disease (Yoav Ben-Shlomo), mental health epidemiology (David Gunnell), nutritional epidemiology (Andy Ness), respiratory disease (Jonathan Sterne), and infectious disease epidemiology (sexually transmitted infections and HIV (Nicola Low, Matthias Egger and George Davey Smith).
Health Services Research
Health services research may be defined as research into all aspects of health technologies and the delivery of health care, and is becoming increasingly more important as it becomes necessary to have reliable information on which to base decisions on the allocation of limited resources, decisions which may well have an ethical component. The defining characteristic of our research in. this area is a multidisciplinary approach, and a concomitant interest in both quantitative and qualitative methodological issues. Research in HSR includes both methodological and applied programmes, with the latter focusing on five main areas: prostate cancer (Professor Jenny Donovan); common potentially disabling conditions of older people (Professors Shah Ebrahim and Paul Dieppe), primary care (including the primary/secondary interface); mental health (David Gunnell) and sexual health (Matthias Egger, Nicola Low, Jonathan Sterne, Tony Ades). One of the departments current priorities is to develop trial methodology, including meta-analysis, to assess the effectiveness of treatments. Evaluative studies incorporate effectiveness, acceptability and cost. Over the last 5 years this programme has expanded with the establishment of the centre of the MRC Health Services Research Collaboration in Bristol.
Dr David Gunnell
Senior Lecturer, University of Bristol
June 2003