Time to break the chains: advancing bio-social understanding of multimorbidity

是时候打破束缚了：推进对多发病的生物社会理解

• 批准号: ES/V012703/1
• 负责人: Leo Singer
• 金额: $ 11.74万
• 依托单位: University of Liverpool
• 依托单位国家: 英国
• 项目类别: Fellowship
• 财政年份: 2020
• 资助国家: 英国
• 起止时间: 2020 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=ES%2FV012703%2F1
• 关键词: Time; break; chains; advancing; bio

The current COVID-19 pandemic highlights in a dramatic way the essential link between human biology and its physical and social environment. The pandemic has thrown multimorbidity into the spotlight as underlying chronic conditions seem to be critical markers of vulnerability and intensive care needs. This project sets out to explore and explain how multimorbidity, the presence of two or more chronic conditions in a person, is a result of bio-social trajectories over the life course, by visiting some of the best researchers in the field and learning new skills; analyzing bio-social linkages on my PhD data; publishing for academic and non-academic target groups; organizing an inter-disciplinary conference at University of Liverpool and a public engagement event with discussions and a short film screening. My PhD research showed that the burden of multimorbidity in the English ageing population is associated with socio-economic, psycho-social and lifestyle circumstances. Developing multimorbidity is not the result of either biological ageing or a consequence of unhealthy lifestyle choices. In general, ageing individuals from better-off backgrounds are healthier than their peers who are worse-off.The first aim of the proposed project is enriching the current debate on multimorbidity with social science perspectives by organising the conference What's the point of Multimorbidity? Biosocial and critical understanding of the concept in July 2021 at UoL. By bringing together medical scientists and clinicians, social scientists, policy makers, patients and members of the public, I want to raise awareness of the social determinants of and inequalities in multimorbidity, and discuss ways forward. This will raise the profile of multimorbidity research and enhance the impact of my past and current research findings. Using a visual approach to communicate the topic, an animated film about ageing lives with multimorbidity will be produced and presented to the community. To effectively engage the public and to formalize regional focus on social aspects of multimorbidity, I will collaborate with the North West Coast Applied Research Collaboration. This network will be translated into my further career plans and funding application to Welcome Trust in January 2021. The second aim of the project is to better predict an early risk of developing multiple health conditions, as this contribution to knowledge can help prevent or delay the accumulation of multimorbidity in later life. Biological markers, often based on physical capacity or blood concentrations of certain molecules, could provide an early and more advanced insight into the onset of multiple chronic conditions. This analysis would extend my PhD life course model of multimorbidity by integrating biomarkers collected in the English Longitudinal Study of Ageing, using advanced features of Structural Equation Modelling. If society wishes to prevent the development of multimorbidity, we need to improve our knowledge of the chains of risk leading from the childhood circumstances to the actual manifestation of multimorbidity. Detecting early signs, measured directly in our bodies as biomarkers, could help identify a window of opportunity to break the chains of risk before multimorbidity develops. These issues have not been explored yet and they present an exciting extension of my PhD.

当前的COVID-19大流行以戏剧性的方式突出了人类生物学与其物理和社会环境之间的重要联系。由于潜在的慢性疾病似乎是脆弱性和重症监护需求的关键标志，此次大流行使多重发病成为人们关注的焦点。该项目旨在通过访问该领域的一些最好的研究人员并学习新技能，探索和解释多重疾病，即一个人存在两种或两种以上的慢性疾病，是生命过程中生物社会轨迹的结果；分析我的博士数据的生物社会联系；面向学术和非学术目标群体的出版；在利物浦大学组织了一次跨学科会议，并组织了一次公众参与活动，包括讨论和短片放映。我的博士研究表明，英国老龄化人口的多重疾病负担与社会经济、心理社会和生活方式环境有关。发展多重疾病既不是生物老化的结果，也不是不健康生活方式选择的结果。一般来说，家境较好的老年人比家境较差的同龄人更健康。拟建项目的第一个目标是通过组织会议，从社会科学的角度丰富当前关于多重疾病的辩论。2021年7月在UoL对该概念进行生物社会和批判性理解。通过召集医学科学家和临床医生、社会科学家、决策者、患者和公众，我希望提高人们对多重疾病的社会决定因素和不平等现象的认识，并讨论前进的道路。这将提高多病研究的知名度，并增强我过去和现在的研究成果的影响。将制作一部关于老年多重疾病生活的动画电影，以视觉方式传达这一主题，并向社区展示。为了有效地让公众参与，并使多病的社会方面的区域重点正式化，我将与西北海岸应用研究合作。这个网络将转化为我进一步的职业规划和2021年1月向欢迎信托基金申请资金。该项目的第二个目标是更好地预测发展多种健康状况的早期风险，因为这一知识贡献可以帮助预防或延缓多种疾病在以后生活中的积累。生物标志物通常基于身体能力或某些分子的血液浓度，可以为多种慢性疾病的发病提供早期和更深入的了解。这一分析将扩展我的博士多病生命历程模型，通过整合在英国老龄化纵向研究中收集的生物标志物，使用结构方程模型的先进功能。如果社会希望防止多重疾病的发展，我们需要提高我们对从童年环境到多重疾病实际表现的风险链的认识。检测早期症状，直接在我们的身体中测量作为生物标志物，可以帮助在多种疾病发展之前找到打破风险链的机会之窗。这些问题还没有被探索过，它们是我博士学位的一个令人兴奋的延伸。