Profile: Professor David Leon
Professor David Leon from the Non-communicable Disease Epidemiology Unit talks about his career and research
"Having been passionate about science at school I got a place at University to study it. However, with only a few weeks to go before my undergraduate life began I decided to take a different course (literally) and opted for philosophy instead; I felt that science was not addressing the big questions about life as I saw them then. Three years later, I emerged with a degree in philosophy and sociology but my interest in science, and medical science in particular, had not disappeared, and this combination of interests led me to epidemiology and the School which I joined as a lecturer in 1985.
My background in sociology and philosophy has provided me with a particularly strong feel for the determinants of health in populations - which is what epidemiology is fundamentally about. Indeed developing an adequate understanding of the determinates of health and disease in populations requires input from a variety of disciplines, from bio-medicine to economics, sociology and anthropology.
As well as the subject area, the scale of the issues I address is deeply satisfying. Over the past decade, for example, I have worked on trying to understand the reasons for the very poor health status of populations in Eastern Europe. With colleagues overseas and from the European Centre on Health of Societies in Transition (ECOHOST), based at the School, I have been particularly intrigued by the massive swings in life-expectancy that have occurred in Russia and other parts of the former-Soviet Union. These are enormous: between 1990 and 1994 life-expectancy among Russian males fell by 6 years! Working on the health problems of Eastern European has led me to become more interested in the determinants of the health of nations in general. We have much to learn about the driving forces behind the very varied changes in health status and morality that have occurred over the course of the 20th Century, and this has provided me with a new theme for my work. Insights from this will provide an essential basis for anticipating the likely health trends as further massive changes in the organisation of nations and the world economy occur.
My interest in the 'big picture' goes alongside a more particular, but closely related, interest in life-course determinants of health. This is an emerging paradigm in epidemiology which challenges the narrow preoccupation with adult lifestyle as the explanation for health trends. The 'fetal-origins hypothesis' developed during the 1990s has been a growing area of my own research. With colleagues in the UK and Sweden, I have been involved in studying the links between impaired growth in utero and risk of disease at later stages of life from adolescence to old age. But this is only part of the life-course picture as there is also evidence that growth and conditions in childhood have effects upon disease rates in later life. By starting to give more weight to circumstances decades prior to the onset of illness, the life-course approach holds out the possibility that we may come to a better understanding of socio-economic differences in health as well as differences between countries. All of this is based on careful consideration and study of detailed biological and social mechanisms in special epidemiological studies, and the School is fortunate in having a focus for this work in the form of a Co-operative Group on Life-course Epidemiology, funded by the Medical Research Council."
Dr Liam Smeeth also works in the Non-communicable Disease Epidemiology Unit
