This project will investigate associations between socioeconomic adversity across life and a range of important musculoskeletal health outcomes. A life course epidemiological approach will be applied to test associations in large population-based studies, complemented by analyses in smaller studies with more detailed physiological measures to elucidate potential mechanisms of association.
Aims and objectives
The primary aim of this research project is to investigate associations between indicators of socioeconomic adversity across life and musculoskeletal health outcomes.
To help meet the needs of our ageing population, the UK Government has set the mission of ensuring ‘that people can enjoy at least 5 extra healthy, independent years of life by 2035, while narrowing the gap between the experience of the richest and poorest’.1 To meet this ambition a number of important challenges need to be addressed urgently. First and foremost is identifying effective strategies to ensure that people live not only longer lives but also healthier lives for longer. As socioeconomic adversity has been identified as an important barrier to healthy ageing,2 also of critical importance is understanding how and when socioeconomic inequalities in health outcomes that pose a threat to independence in later life emerge and what can be done at different stages of life to alleviate the detrimental impacts of exposure to socioeconomic adversity.
Current population projections suggest that over the next few decades there will be a significant rise in the number of people living with complex multi-morbidities. This poses a major threat to achieving the ambition of extending people’s healthy life expectancy. While a wide range of different diseases and disorders contribute to the burden of multi-morbidity in older adults, there is consistent evidence that musculoskeletal health outcomes are some of the most important contributors3 and are also key precipitants of loss of independence. Furthermore, there is evidence that the global burden of musculoskeletal diseases is increasing.4
This project will improve our understanding of how different indicators of socioeconomic adversity across life relate to a range of different musculoskeletal health outcomes in adulthood, how these differ by age and cohort and what physiological and behavioural mechanisms may explain these associations. It will, therefore, help inform work required to identify the most suitable, timely and effective opportunities to improve people’s chances of living healthier lives for longer and to reduce inequalities in accessing these opportunities.
Epidemiological analyses will be undertaken to test key research questions. This will include an assessment of how indicators of socioeconomic position in childhood relate to: i) trajectories of functional limitations across adulthood and; ii) clusters of musculoskeletal symptoms, including pain and fatigability, in old age. The factors that may mediate these associations, including physical activity and obesity, will also be investigated.
Research questions will be addressed using data from a number of different population-based studies including the British birth cohorts (nationally representative studies of thousands of people who have been followed up since birth in different decades of the twentieth century) and UK Biobank (a major national resource including half a million people aged 40-69). There will also be opportunities to use data from electronic health records.
To elucidate underlying mechanisms of associations, complementary work will be undertaken in smaller studies with more detailed physiological and biomechanical measures. In planning for these analyses there will be an opportunity to inform and contribute to data collections ongoing within Manchester Met.
This PhD studentship presents an exciting opportunity to join a dynamic, interdisciplinary research centre with international expertise in musculoskeletal science as they expand their research portfolio to incorporate more epidemiological research. It also presents a great opportunity to undertake research that will directly inform current national and international policy initiatives to improve the lives of our ageing population.
2 Cooper R ‘Socioeconomic adversity – an important barrier to healthy ageing’ British Medical Journal 2018;360:k1288
4 Sebbag E et al ‘The worldwide burden of musculoskeletal diseases: a systematic analysis of the World Health Organization Burden of Diseases database’ Ann Rheum Disease 2019 doi:10.1136/annrheumdis-2019-215142