Skip Navigation | ANU Home | Search ANU | Directories

Thai Health-Risk Transition: A National Cohort Study

AIMS

This study is a unique opportunity for collaborative public health research between Thailand and Australia that tackles important issues for population health. The partnership will develop new research capacity in Thai and Australian universities. We aim to have a substantial long-term impact on regional population health by enabling Thailand to understand and mitigate emerging disease trends. The research began in 2004 and will document changes in health risk and disease patterns over time and seek information to enable feasible interventions to reduce disease burdens.

In summary, the Thai Cohort Study will map the changing health-risks and focus on upstream processes and proximal risk factors, on secular health trends and the potential for interventions. Economic, cultural, social, behavioural and environmental changes shifting the overall risk of the Thai population will be studied to inform preventive programs, boost regional research capacity, and create a regional partnership.

BACKGROUND

Thailand 's dynamic economic development has been accompanied by great changes in cultural, social, environmental and other forces that shape population health in ways that are poorly understood. Socio-economic development in Thailand is already causing profound changes in population health - some positive, but others such as emerging diabetes, heart disease and injuries are of great concern.

FUNDING

The National Health and Medical Research Council (NHMRC) of Australia and The Wellcome Trust in the United Kingdom (UK) have funded this large study of the complex health-risk transition in Thailand, to enable understanding of causal phenomena which affect many other populations.

THE STUDY

The study comprises both historical and prospective aspects and uses an array of methods, including observation of a large national cohort. First we note the Thai context by studying the social, economic, risk factor and health changes in the whole population over the last 50 years using existing historical socio-economic and health data. Then we will follow a large cohort of 88,000 Thai students enrolled at STOU - an accessible group likely to experience change in material circumstances. STOU students are not affluent but are upwardly mobile, live throughout the country and can take about seven years to complete their degrees.

Thus we will measure the distribution, and the time course of changes (ie the 'risk transition'), of many proximal ('downstream') health-risk factors such as working-living conditions, personal lifestyle and behaviours, and health care use. We will do this at baseline and after four years. During the four-year follow-up, a series of ancillary studies of cohort sub-sets will investigate 'upstream' influences on risk transitions: structural factors (eg social stratification, occupation, wealth and resource redistribution) and systemic factors (eg the Thai environment, human ecology, social system, specific cultural influences).

RESULTS

We will learn how current and future risk distributions and transitions vary among sub-groups (eg young/old, rural/urban, rich/poor), how they link to specific disease outcomes, and what evidence-based interventions are needed in Thailand to substantially reduce future disease burdens.

RESEARCHERS

The research team is headed by two principal investigators, with 13 co-investigators from four universities and two Thai government institutions: National Centre for Epidemiology and Population Health, The Australian National University; School of Population Health, The University of Queensland; School of Human Ecology, Sukhothai Thammathirat Open University; Chiang Mai University; Thai Ministry of Public Health; Office of National Economic and Social Development Board.

PhD research scholarships have been awarded to three Thai and two Australian researchers whose research topics include sexual health transition, projecting future health outcomes for the STOU cohort, birthing and maternal health transition, transport transitions and automobility and, economic modelling of the inequalities of the health transition.

Contact: Adrian Sleigh