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Background

Myocardial infarction (MI) is one of the leading causes of death in the UK and globally. Previous work has shown that age-standardised mortality rates from MI declined by about half between 2002 and 2010 in the UK. Half of this decline was due to a fall in incidence and half due to improved case-fatality rates1. This work provided important information about the incidence and case fatality of MI in the general population, but it is important to understand if this varies by sub-populations of the UK to prevent inequalities in incidence or case-fatality from either developing or widening.

There is limited information available on the variation in incidence and case-fatality of MI by ethnic group. Earlier studies have shown that there is variation by country of birth for coronary heart disease and stroke mortality, which is a proxy for ethnic group2. Around 50% of some UK ethnic minority groups were born in the UK, therefore people who identify to a particular ethnic group, but were born in the UK are not included in analyses by country birth.

This DPhil would build on a previous project which explored time trends in MI incidence and case-fatality in the general population, using Hospital Episode Statistics linked to mortality data. Hospital episode statistics in England cover the entire English population that have been admitted to hospital. This dataset can be linked to mortality data from the ONS to provide incidence and case-fatality data.

The aim would be to understand how incidence and case-fatality of MI varies by ethnic group in England, how this has changed over time, and whether there are significant differences between UK regions.

References        

  1. K Smolina, L Wright, M Rayner, M J Goldacre. Determinants of the decline in mortality from acute myocardial infarction in England between 2002 and 2010: linked national database study. BMJ 2012;344:d8059
  2. S.H. Wild, C. Fischbacher, A. Brock, C. Griffiths, and R. Bhopal. Mortality from all causes and circulatory disease by country of birth in England and Wales 2001–2003. J Public Health 2007 29 (2): 191-198

Research experience, research methods, and skills training

This DPhil project will develop experience of:

  • Systematic reviews
  • Managing large datasets
  • Statistical techniques

Field work, secondments, industry placements, and training

DPhil candidates will be able to attend relevant training courses and will learn how to present their findings at research meetings.

Prospective candidate

The candidate should have some existing knowledge of statistics and have a genuine interest in health inequalities and cardiovascular disease epidemiology.

Supervisors

Projects