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Blake Thomson: Addressing global health disparities

How long have you been working at The George Institute?

Since January 2020.

What is your professional background?

I’m an epidemiologist with a particular focus on quantitative global health research. I began my training as a Post-Bachelor Fellow at the Institute for Health Metrics and Evaluation (IHME) working on the Global Burden of Disease (GBD) Study, among other projects. I started to see the gaps that epidemiological research could fill, and the implications for people all over the world, and I was hooked. I went on to study Epidemiology at the University of Cambridge for my Master’s degree and Population Health here at Oxford for my doctorate. Throughout my career I’ve focused primarily on risk factors for non-communicable diseases, such as smoking, diabetes, and obesity.

What attracted you to working at The George Institute?

I saw The George Institute playing an important role in shaping the global health research agenda, and I wanted to contribute to that effort. Population health research has the potential to improve people’s lives, and that’s a key motivation at The George Institute.

What are you currently working on?

My main focus is using information from large prospective studies to quantify the relevance of modifiable risk factors like smoking and obesity to mortality. In particular, my research hones in on disparities, searching for answers as to why they exist, and what can be done to address them.

For example, it has consistently been shown in places like the UK and the US that, in relative terms, diabetes poses a greater risk of vascular death among women than among men. The question is, why? Are women less likely to receive the right medical care? Is this disparity driven by differences in other risk factors between women and men? Do biological differences play a role? Disentangling these relationships can give us a better sense of how to prevent and control disease—not just for women or men, but for everyone.

More broadly, I’m interested in health systems, emerging risk factors, shifting disease trends, and how we improve global health in the bigger picture. I am usually working on a handful of side projects related to these themes.

What is a recent highlight?  

I had an article published in Circulation, written with collaborators at Oxford, about how the potential shift towards an expanded single-payer healthcare system in the United States could transform the way medical research is done. To illustrate, we gave examples of research conducted in partnership with the UK's National Health Service. It was an idea that had been on my mind for a while, so I was pleased that someone else agreed that it was worth thinking about!

What difference will this make to healthcare and why?

Technology has transformed how health research can be done, but by and large, those developments haven’t yet changed how such research is done. Nowadays, in many cities and countries, medical records are stored electronically. Participants in research studies can be reached in a variety of ways using smart phones and computers. We have more techniques than ever to take a small blood sample and turn it into seemingly endless amounts of quantitative information, telling us about the genome, biomarkers, and much else. We are now in the ‘Big Data’ era, and leveraging this information can help us accelerate and strengthen virtually any research study. Done well, that can translate to targeted prevention, better treatments, and clearer answers about what makes us sick, and what we can do about it. Researchers in the UK and elsewhere have really been turning these ideas into actions—and their centralised healthcare system has played a major role in that.

Why do you enjoy working at The George Institute?

I get to work with brilliant people from all over the world towards the shared goal of improving global health.

To explain to people what I do, I say…

I study the health effects of things like smoking and diabetes (and I facetiously add that, as it turns out, they’re bad for you). Of course, knowing whether something is good or bad for us is just the starting point. It’s really important to understand how prevalent the risk factor is, quantify its health impact in relative and absolute terms, and identify disparities (like whether it is more common, or more harmful, depending on one’s age, sex, socioeconomic status, and so on). This guides evidence-based policies, and individual habits, to prevent and control disease.

It’s research like this that established that smokers in the UK and elsewhere lose an average of 10 years of life expectancy compared to never smokers, but that those who quit by age 40 (and ideally well before age 40) can gain 9 or even all 10 of those years back. Smoking kills, but quitting really works!

To unwind at the end of the day I…

I think my family and friends wish I spent less time thinking (and talking) about global health. I get way too excited about the work I get to do, so I have a hard time pulling myself away. But when I do, I love reading literature (mostly 19th century fiction) and science writing. Whenever it’s sunny, I enjoy cycling around lovely Oxfordshire.

My first job was…

My first job was as a research fellow on the Global Burden of Disease (GBD) Study in Seattle, Washington, which is where I learned to write code, put together academic manuscripts, and work on a collaborative research team. The GBD is a massive undertaking, but it is critically important, so it was very motivating to follow through and really work hard to get things right. I worked with over 1,000 datasets from across the globe, which taught me a lot about health data—what’s out there, what questions it can answer, and what additional information is needed. It has been a great foundation for my research career. Living in Seattle also prepared me for the British weather!

My biggest achievement so far…

The work that the global health research community does is so collaborative that it’s difficult to take too much credit. That being said, I’m proud of the work I’ve been able to do with teams of researchers in Oxford, Cambridge, Seattle, Havana, and Mexico City. Our research on smoking, diabetes, and obesity has appeared in journals such as The Lancet, JAMA, and the International Journal of Epidemiology, and hopefully has started influencing people and policy.