Centre for Global Health Policy

Group Discussion Sessions

During the workshop, there will ve a number of group discussions on the following themes:

 

 

A: Moving from individual to population health indicators – led by Prof. Torvid Kiserud (University of Bergen) and Prof. Frans van Poppel (University of Utrecht)

Medical practitioners generally focus on indicators that measure an individual’s health, but these indicators may not be the most helpful for tracking changes in population health. For instance, low birth weight (below 2,500 grams) corresponds to many health problems for individuals, but the percentage of children born with low birth weight is a problematic proxy for population early life health since it ignores other moments of the birth weight distribution, which can also influence health. This session will explore ways to adapt individual early life health indicators to best measure the early life health of a population, including length and weight at birth, ponderal index, prematurity, and other indicators. The session will also include discussion of the feasibility of applying these indicators in a historical setting and around the world today.

 

B: Social and economic determinants of early life health – led by Prof. Sabu Padmadas (University of Southampton) and Assistant Prof. Gabriella Conti (University College London)

Recent research has highlighted the considerable influence of social and economic factors on many health outcomes. These factors are known to strongly influence pregnancy outcomes around the world today and also shaped early life health in the past. Understanding the social and economic determinants of early life health in the past and around the world can provide insight into the types of interventions that may be needed to improve early life health today. This session will explore the social and economic determinants of early life health, focusing on the following questions: How do gender disparities in health, income inequality, unequal access to healthcare, housing, sanitation, etc. influence early life health? To what extent do these social and economic factors limit the effectiveness of health interventions? Would they limit the improvements in early life health that we would otherwise expect? How do social and economic factors influence specific proxies for early life health being discussed at the workshop? Would social or economic factors lead to any systematic biases in the proxies collected; for instance, are poor people less likely to register neonatal deaths than rich people?

 

C: The relationships between fetal development, birth weight, stillbirth, and neonatal and infant mortality – led by Prof. Gerard Visser (University Medical Center Utrecht), Dr Sarah Neal (University of Southampton) and Dr Alice Reid (University of Cambridge)

Stillbirth and infant mortality data are more prevalent than birth weight data both historically and today. If there were greater clarity about the relationship between fetal development, birth weight and mortality, these proxies could be used more effectively to verify and extend our knowledge of early life health. This session will discuss these relationships and the questions they raise in detail. For instance, to what extent do stillbirth, neonatal and infant mortality rates reflect fetal development? How are these relationships clouded by historical and spatial variations in obstetric care; abortion, infanticide and child abandonment; and the virulence of the disease environment? To what extent do data quality issues make these inferences problematic? What levels of stillbirths and neonatal mortality rates would reflect good early life health conditions and how do these correspond to other early life health indicators? Are mortality indicators more reliable as a proxy for early life health than birth weight and other indicators?

 

D: Trans-generational transmission of early life health – led by Prof. Rebecca Reynolds (University of Edinburgh) and Prof. Sonia Bhalotra (University of Essex)

Cohort studies suggest that trans-generational transmission of early life health may be significant and partially dependent on socioeconomic conditions. This small group session will explore this in detail, considering the following questions: How significant is trans-generational transmission of early life health? What mechanisms underpin this transmission? To what extent does trans-generational transmission slow expected improvements in early life health, weakening the effects of health interventions? Do these trans-generational effects influence some early life health proxies more than others? In what ways can thinking about early life health across generations enhance our understanding of early life health disparities around the world today? What kind of evidence could economic and demographic historians collect for the past couple of centuries to track trans-generational transmission of early life health?