Farr Institute @ Scotland
A few members of the SCPHRP are involved with the new Farr Institute @ Scotland. The Farr Institute @ Scotland is a national centre which brings together researchers from six Scottish Universities with experts from NHS National Services Scotland with the aim of producing high-quality cutting edge research using electronic health records. The two primary themes of the Farr Institute @ Scotland are ‘Health, illness and society through time’ and ‘Studies of interventions’. John Frank and Ruth Jepson are co-investigators on the ‘Health, illness and society through time’ theme, and in particular Larry Doi is undertaking research into the early life epidemiology of obesity. Within the ‘Studies of interventions’ John Frank and Ruth Jepson are co-investigators on the subtheme ‘Evaluating natural experiments using data linked across sectors’, for which Andrew James Williams is the Research Fellow.
Alongside the Farr Institute @ Scotland there are three other Farr Institutes across the UK; @ London, @ HeRC N8 (North England) and @ CIPHER (Wales). The intention is that researchers from the different Farr Institutes will develop collaborative research projects which span across the UK.
Many of the influences on our health are not amenable to examination using traditional techniques like randomised controlled trials. For example it is impractical and potentially unethical to randomise people to live in different environments. However, sometimes randomisation occurs as part of nature or other processes enable a natural experiment. A widely recognised early example of a natural experiment is the work of John Snow who compared cholera deaths among those collecting their water from different pumps. His findings enabled him to propose that cholera was transmitted in water many years before the bacteria Vibrio cholerae transmitted through contaminated water was widely recognised as the cause. Natural experimental approaches can be used to evaluate policies, and consequently such evaluations are a new project for the SCPHRP. One policy which we are evaluating to see if there was an impact on hospital admissions using natural experimental approaches is the abolition of prescription fees in Scotland.
This particular project will also collect information on what makes a natural experiment feasible. Furthermore, we will look for innovative way to apply natural experimental approaches and develop the techniques for application to other public health related interventions. Within the Farr Institutes it will be possible to evaluate the health impacts of differences in policy between the different countries of the UK.