Healthy ageing in EAst London (HEAL): Measuring and modelling healthy ageing inequalities to inform action in East London

Not everyone gets the opportunity to age healthily. For example, healthy life expectancy (the number of years a person can expect to live in good health) in Tower Hamlets is around 59, a whole 5 years less than the London average and over a decade less than in Richmond (ONS). There is no consensus measure of healthy ageing. Existing measures capture different aspects of health, function, ill-health, disability, and multimorbidity, and are often produced inconsistently, infrequently, extrapolated from small samples, and/or at an aggregated levels – making it difficult for policymakers to identify where inequalities arise and which interventions are most likely to reduce them. 

This PhD will develop and apply a robust framework for measuring healthy ageing and understanding inequalities using linked electronic health records. The student will develop skills in evidence synthesis, stakeholder engagement, using electronic health records, epidemiology, statistical modelling for multistate analyses, health inequalities, and translation into policy. 

The overarching aim is to develop a practical framework for measuring healthy ageing, identify the drivers of inequalities in healthy ageing, and apply this framework to support decision-making in East London. 

Objectives:
Year 1 – Conduct a methodological review of measures of healthy ageing and health inequalities; engage stakeholders to identify the most meaningful outcomes to local communities/decision-makers; obtain approvals for ELSA, CPRD and East London datasets.
Year 2 – Develop multistate models of healthy ageing using ELSA and CPRD linked data; quantify inequalities by sex, ethnicity, deprivation, and other factors; identify potentially modifiable drivers of earlier transitions to unhealthy ageing.
Year 3 – Apply and refine the framework using East London datasets; assess how well national findings translate to the local population; work with local stakeholders to integrate healthy ageing metrics into local policy decisions; model the potential impact of reducing key risk factors on healthy ageing inequalities.
Year 4 – Finalise analyses, disseminate findings through publications and stakeholder workshops, and co-develop practical recommendations to inform policies aimed at improving healthy ageing and reducing inequalities in East London.