Today we understand the factors shaping our health incomparably better than a generation ago. Next year marks 20 years since the mapping of the human genome, in which the UK played a leading role.
But now the challenges look different. A healthy future means putting prevention at the heart of healthcare: striking a better balance between treating the sick and keeping the healthy healthy. It also demands we tackle the terrible health inequality problem that was exposed by the pandemic, and today accounts for a roughly 20-year difference in healthy life expectancy between richest and poorest.
We know these differences in health outcomes are driven more by society than biology, and in the US at least around 80-90 per cent of these social determinants have little to do with clinical care. But compared to the depth of our understanding of our physiology, our understanding of how our surroundings influence our health is poor. Yet we now have the tools to change this—the data revolution in every aspect of our lives means we can take science “out of the lab” and into our cities, communities and homes. This would reveal the complex patterns and vital clues that link our environment, behaviours and health.
This world of data paves the way to another holy grail of health akin to the genome, the “exposome”—the system of all external factors that influence our health and wellbeing trajectory. Building on existing efforts in the US and elsewhere, charting the exposome would deliver deep insights into the underlying causes of disease itself. We simply do not and will not gain these insights without connecting genetics, biological, behavioural, environmental and financial data. The answers are there.
A healthy future means putting prevention at the heart of healthcare.
This won’t be without challenges. While the technical complexity is immense, more difficult will be encouraging citizens to share health-relevant data at scale, requiring serious thought and safeguards around privacy and (anonymised) data. But if open banking is possible, open health should be too. The prize is huge for both the health and wealth of the nation. For example, by delving deep into the complexities of the ageing process that underlies all chronic diseases, which devour much of the health services budget.
As with the genome, the UK is uniquely placed to lead this endeavour. With smart regulation, the UK could become the centre of this global effort—a living lab—anchored in the unmatched data opportunities offered by the NHS as the world’s largest healthcare system, and connecting this data to other health-relevant data across our lives to understand the intricate mechanisms keeping us in good health. These insights can be applied to infrastructure, services and policies to create environments in which people thrive.
When scientists mapped the genome 20 years ago, they wouldn’t have imagined that just two decades hence we would have the data and technology to make mapping the exposome possible, and even credible for a moonshot investment. Now that we do, what better way to commemorate their achievement by embarking on a “Healthy Longevity Innovation Mission”, supported by the government and private sector to nurture healthy people, a healthy planet and healthy growth?
This article was originally published as part of Minister for the Future in partnership with Prospect. Illustrations by Ian Morris. You can read the original feature on the Prospect website.